SurFuse Gel, SurFuse Putty, ExFuse Gel, ExFuse Putty

K171568 · Hans Biomed Corporation · MQV · Feb 22, 2018 · Orthopedic

Device Facts

• Record ID: K171568
• Device Name: SurFuse Gel, SurFuse Putty, ExFuse Gel, ExFuse Putty
• Applicant: Hans Biomed Corporation
• Product Code: MQV · Orthopedic
• Decision Date: Feb 22, 2018
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 888.3045
• Device Class: Class 2
• Attributes: Therapeutic

Intended Use

SurFuse™ Gel, SurFuse™ Putty, ExFuse™ Gel, ExFuse™ Putty products are indicated for bony voids or gaps that are not intrinsic to the stability of the bone structure. They are intended to be gently packed into bony voids or gaps of the skeletal system as a bone void filler in the extremities and pelvis. These defects may be surgically created osseous defects or osseous defects created from traumatic injury to the bone. These products resorb and are replaced with bone during the healing process.

Device Story

Resorbable bone void filler composed of human demineralized bone matrix (DBM), cancellous bone powder, and carboxymethylcellulose (CMC) carrier. Used in institutional/hospital settings by clinicians to fill non-structural bony voids in extremities and pelvis. Device acts as osteoconductive scaffold for new bone regeneration; DBM component provides osteoinductive potential. Supplied sterile in syringes (0.3cc to 10cc). Resorbs over time and is replaced by host bone during healing. Benefits patient by facilitating bone repair in osseous defects.

Clinical Evidence

No human clinical data. Evidence includes in vivo rabbit unicortical defect model testing for osteoconduction and in vivo athymic (nude) rat muscle pouch model for osteoinductive potential. In vitro BMP-2 ELISA assay used as a surrogate for lot-to-lot evaluation of osteoinductive potential, correlated with rat model results.

Technological Characteristics

Resorbable bone void filler; materials: human demineralized bone matrix (DBM), cancellous bone powder, carboxymethylcellulose (CMC). Osteoconductive scaffold; osteoinductive potential. Supplied sterile for single-patient use. Volumes: 0.3cc to 10cc. Biocompatibility per ISO 10993.

Indications for Use

Indicated for patients with bony voids or gaps in the skeletal system (extremities and pelvis) that are not intrinsic to bone structure stability, including surgically created or traumatic osseous defects.

Regulatory Classification

Identification

A resorbable calcium salt bone void filler device is a resorbable implant intended to fill bony voids or gaps of the extremities, spine, and pelvis that are caused by trauma or surgery and are not intrinsic to the stability of the bony structure.

Special Controls

*Classification.* Class II (special controls). The special control for this device is the FDA guidance document entitled “Class II Special Controls Guidance: Resorbable Calcium Salt Bone Void Filler Device; Guidance for Industry and FDA.” See § 888.1(e) of this chapter for the availability of this guidance.

Predicate Devices

• DBX® Demineralized Bone Matrix Putty (K103784)
• SurFuse™ Gel, SurFuse™ Putty, ExFuse™ Gel, ExFuse™ Putty (K113728)

Submission Summary (Full Text)

{0}------------------------------------------------

Image /page/0/Picture/0 description: The image contains the logo of the U.S. Food and Drug Administration (FDA). On the left is the Department of Health & Human Services logo. To the right of that is the FDA logo, which consists of the letters "FDA" in a blue square, followed by the words "U.S. FOOD & DRUG" and "ADMINISTRATION" in blue text.

February 22, 2018

Hans Biomed Corporation % Patsy J. Trisler, JD, RAC Regulatory Consultant Trisler Consulting 5600 Wisconsin Avenue, #509 Chevy Chase, Maryland 20815

Re: K171568

Trade/Device Name: SurFuse™ Gel. SurFuse™ Putty. ExFuse™ Gel. ExFuse™ Putty Regulation Number: 21 CFR 888.3045 Regulation Name: Resorbable calcium salt bone void filler device Regulatory Class: Class II Product Code: MOV, MBP Dated: January 12, 2018 Received: January 16, 2018

Dear Ms. Trisler:

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 of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820);

{1}------------------------------------------------

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 http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

For comprehensive regulatory information about medical devices and radiation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/) and CDRH Learn (http://www.fda.gov/Training/CDRHLearn). 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 (http://www.fda.gov/DICE) for more information or contact DICE by email ([e-mail]) or phone [phone] or 301-796-7100).

Sincerely,

# Mark N. Melkerson -S

Mark N. Melkerson Director Division of Orthopedic Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

{2}------------------------------------------------

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) K171568

Device Name

SurFuseTM Gel, SurFuseTM Putty, ExFuse™ Gel, ExFuseTM Putty

#### Indications for Use (Describe)

SurFuse™ Gel, SurFuse™ Putty, ExFuse™ Gel, ExFuse™ Putty products are indicated for bony voids or gaps that are not intrinsic to the stability of the bone structure. They are intended to be gently packed into bony voids or gaps of the skeletal system as a bone void filler in the extremities and pelvis. These defects may be surgically created osseous defects or osseous defects created from traumatic injury to the bone. These products resorb and are replaced with bone during the healing process.

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)

### CONTINUE ON A SEPARATE PAGE IF NEEDED.

This section applies only to requirements of the Paperwork Reduction Act of 1995.

### *DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.*

The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:

> Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff [e-mail]

"An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number."

{3}------------------------------------------------

# Section 5.0 510(k) SUMMARY

| Submitter Name: | Hans Biomed Corp. |
|-------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Submitter Address: | 64, Yuseong-daero 1628beon-gil, Yuseong-gu, Daejeon,<br>Republic of Korea |
| Contact Person: | Ms. Lucy Choi |
| Phone Number: | 82 2 466 2266 |
| Fax Number: | 82 2 463 1554 |
| Date Prepared: | May 30, 2017 |
| Device Trade Name: | SurFuse™ Gel, SurFuse™ Putty, ExFuse™ Gel, ExFuse™ Putty |
| Device Common Name: | Resorbable Calcium Salt Bone Void Filler Device |
| Classification Number: | 21 CFR 888.3045 |
| Product Code: | MQV, MBP |
| Classification Name: | Filler, bone void, calcium compound |
| Device Class: | II |
| Predicate Devices: | Primary: K103784, DBX® Demineralized Bone Matrix Putty,<br>Musculoskeletal Transplant Foundation<br>Reference: K113728, SurFuse™ Gel, SurFuse™ Putty, ExFuse™<br>Gel, ExFuse™ Putty, Hans Biomed Corp. |
| Statement of Intended<br>Use: | SurFuse™ Gel, SurFuse™ Putty, ExFuse™ Gel, ExFuse™ Putty<br>products are indicated for bony voids or gaps that are not intrinsic<br>to the stability of the bone structure. They are intended to be<br>gently packed into bony voids or gaps of the skeletal system as a<br>bone void filler in the extremities and pelvis. These defects may be<br>surgically created osseous defects or osseous defects created from<br>traumatic injury to the bone. These products resorb and are<br>replaced with bone during the healing process. |
| Device Description | Device Identification and Materials of Use:<br>The submitted devices are resorbable bone void filler, combining<br>Human Demineralized Bone Matrix (DBM) with cancellous bone<br>powder and carboxymethylcellulose (CMC).<br>The primary component of SurFuse™ and ExFuse™ is<br>demineralized particle bone which is derived from human donor<br>cortical bone. The additional bone powder in the ExFuse™ is<br>derived from human donor cancellous bone.<br>The CMC is added to enhance the cohesiveness of the composition. |

{4}------------------------------------------------

# Device Characteristics:

The submitted devices are provided in several volumes ranging from 0.3cc to 10 cc. The devices are supplied sterile for single patient use.

### Body Contact:

The submitted devices are a permanent resorbable device, implanted in bone tissue.

## Mechanism of Action:

The submitted devices resorb over time and remodel providing an osteoconductive scaffold for regeneration of new bone. In addition, because the devices are composed primarily of DBM, they have osteoinductive potential.

# Environment of Use:

The submitted devices are for use only in institutional health care or hospital environments.

# Serological Testing & Biocompatibility:

The donor bone is obtained from AATB-certified tissue banks in the United States and screened for:

- antibodies to the human immunodeficiency virus, type1 and type2 (anti- HIV-1 and anti-HIV-2);
- . nucleic acid test (NAT) for HIV-1:
- . hepatitis B surface antigen (HBsAg);
- . nucleic acid test (NAT) for the hepatitis B virus (HBV);
- total antibodies to hepatitis B core antigen (anti-HBc-total, meaning IgG and IgM);
- o antibodies to the hepatitis C virus (anti-HCV);
- nucleic acid test (NAT) for HCV; and
- syphilis (a non-treponemal or treponemal-specific assay may o be performed)

The manufacturing and sterilization processes were assessed for viral inactivation potency by a validation assessment which includes Human Immunodeficiency Virus-1 (HIV-1), Bovine Herpes Virus (BHV), Bovine Viral Diarrhea Virus (BVDV), Hepatitis A Virus (HAV) and Porcine Parvovirus (PPV). The validation assessment observed complete inactivation of inoculated viral titers.

Biocompatibility testing, according to ISO 10993, has been performed and the device has been shown to be safe, non-toxic and biocompatible.

{5}------------------------------------------------

| Performance: | Osteoconduction and Performance as a Bone Void Filler: |
|-------------------------|-------------------------------------------------------------------------------------------------------------------------------------|
| | The submitted devices were tested successfully to fully assess the |
| | performance to grow bone in the in vivo rabbit unicortical defect |
| | model. |
| | Osteoinductive Potential: |
| | They also have been tested in vivo in the athymic (nude) rat muscle |
| | pouch model and were shown to have osteoinductive potential, in |
| | that new bone grew within the muscle tissue. The osteoinductive |
| | potential also was evaluated with a surrogate, in vitro BMP-2 |
| | ELISA, assay. Results from that assay were correlated with results |
| | from the same lots in which bone successfully formed in the |
| | athymic rat. Each lot of the device will be evaluated for |
| | osteoinductive potential using the in vitro assay. |
| | Osteoinduction assay results observed in surrogate assessments |
| | should not be interpreted to predict clinical performance in human |
| | subjects. |
| Comparison to the | The submitted devices have the same intended use as the primary |
| Predicate Devices: | predicate device. |
| | The devices contain the same base osteoconductive material, |
| | DBM, as all predicate devices. They are provided in a syringe |
| | package and contain an additional carrier, as all predicate devices. |
| | The submitted devices are manufactured in the same facility and |
| | sterilized in the same establishment as the supporting predicate |
| | devices, SurFuse™ Gel & Putty and ExFuse™ Gel & Putty |
| | (Κ113728). |
| Substantial Equivalence | The comparisons summarized above and the study data presented |
| Conclusion: | in the 510(k) lead to the conclusion that the submitted bone void<br>filler devices are substantially equivalent to the primary and |
| | supporting predicate devices. |