U.S. Food & Drug Administration 10903 New Hampshire Avenue Doc ID# 04017.02.11 Silver Spring, MD 20993 www.fda.gov June 20, 2018 Paragon Medical ℅ Dave Yungvirt Third Party Review Group, LLC The Old Station House 24 Lackawanna Place Millburn, New Jersey 07041 Re: K173615 Trade/Device Name: Stryker Universal Select Sterilization Tray System Regulation Number: 21 CFR 880.6850 Regulation Name: Sterilization wrap Regulatory Class: Class II Product Code: KCT Dated: April 5, 2018 Received: April 9, 2018 Dear Dave Yungvirt: This letter corrects our substantially equivalent letter of April 18, 2018. 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
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The Old Station House 24 Lackawanna Place …Maximum Weight 25 lbs / 11.36 kg 25 lbs / 11.36 kg 1 Tray System has been validated in the following Aesculap SterilContainer cleared for
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U.S. Food & Drug Administration 10903 New Hampshire Avenue D o c I D # 0 4 0 1 7 . 0 2 . 1 1 Silver Spring, MD 20993 www.fda.gov
June 20, 2018
Paragon Medical
℅ Dave Yungvirt
Third Party Review Group, LLC
The Old Station House
24 Lackawanna Place
Millburn, New Jersey 07041
Re: K173615
Trade/Device Name: Stryker Universal Select Sterilization Tray System
Regulation Number: 21 CFR 880.6850
Regulation Name: Sterilization wrap
Regulatory Class: Class II
Product Code: KCT
Dated: April 5, 2018
Received: April 9, 2018
Dear Dave Yungvirt:
This letter corrects our substantially equivalent letter of April 18, 2018. 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
Page 2 - Dave Yungvirt K173615
requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part
801); medical device reporting (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);
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 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 ([email protected]) or phone
(1-800-638-2041 or 301-796-7100).
Sincerely,
For Tina Kiang, Ph.D.
Acting Director
Division of Anesthesiology,
General Hospital, Respiratory,
Infection Control, and Dental Devices
Office of Device Evaluation
Center for Devices and Radiological Health
Enclosure
Elizabeth F. Claverie -S
510(k) Number (if known)
K173615
Device Name
Stryker Universal Select Sterilization Tray System
Indications for Use (Describe)
The Stryker Universal Select Sterilization Tray System is intended to organize, enclose, sterilize, transport and store Stryker implantable devices and surgical instruments within a healthcare facility when used in conjunction with a validated, FDA cleared rigid sterilization container in order to maintain sterility of the enclosed devices. The Stryker Universal Select Sterilization Tray System has been validated for use in the following sterilization cycles:
Pre-vacuum Steam
Enclosure Rigid Container1 Rigid Container1 Temperature 132°C (270°F) 135°C (275°F) Sterilization Time 4 minutes 3 minutes Minimum Dry Time 30 minutes 30 minutes Maximum Weight 25 lbs / 11.36 kg 25 lbs / 11.36 kg
1 Tray System has been validated in the following Aesculap SterilContainer cleared for pre-vacuum steam sterilization under K792558: Full DIN JK444 (base) and JK489 (lid) and ½ DIN JK346 (base) and JK389 (lid).
The maximum validated product loads for the trays in containers are as follows:
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 thetime to review instructions, search existing data sources, gather and maintain the data needed and completeand review the collection of information. Send comments regarding this burden estimate or any other aspectof this information collection, including suggestions for reducing this burden, to:
Department of Health and Human ServicesFood and Drug AdministrationOffice of Chief Information OfficerPaperwork Reduction Act (PRA) [email protected]
“An agency may not conduct or sponsor, and a person is not required to respond to, a collection ofinformation unless it displays a currently valid OMB number.”
FORM FDA 3881 (7/17) Page 1 of 2 PSC Publishing Services (301) 443-6740 EF
510(k) Number (if known)
K173615
Device Name
Stryker Universal Select Sterilization Tray System
Indications for Use (Describe)Configuration1 Maximum Validated Load Set Contents2,5
3-Level Rack – Qty. 2
(29-13910) in a Full DIN Rigid Sterilization Container3
29-12900 1.2 Upper-Face Plates/Screws Module with Lid (29-13941)
29-12901 1.2 Orbital Plates/Mesh Module with Lid (29-13941)
29-17900 1.7 Mid-Face Plates/Screws Module with Lid (29-13941)
29-17901 1.7 Mid-Face Plates Module with Lid (29-13941)
29-17903 1.7 Orthognathic Plates Inlay
29-13901 Upper-/Mid-Face Instrument Tray with Lid (29-13921)
29-13920 ¼ DIN Instrument/Accessory Tray with Lid (29-13921)
29-23900 2.0/2.3 Mandible Screws Module with Lid (29-13941)
29-23901 2.0/2.3 Mandible Plates Module with Lid (29-13941)
29-23905 2.0/2.3 Mini Plates Inlay, Large
29-13904 Mandible Fracture Instrument Tray with Lid (29-13921)
29-13905 Trocar Instrument Tray with Lid (29-13921)
3-Level Rack – Qty. 1 (29-13910) in a ½ DIN Rigid Sterilization Container4
29-23900 2.0/2.3 Mandible Screws Module with Lid (29-13941)
29-23903 2.0/2.3 Mandible Recon Plates Module with Lid (29-13941)
29-13904 Mandible Fracture Instrument Tray with Lid (29-13921)
29-13905 Trocar Instrument Tray with Lid (29-13921)
29-13906 Mandible Reconstruction Instrument Tray with Lid (29-13921)
29-13920 ¼ DIN Instrument/Accessory Tray with Lid (29-13921) 1 Model numbers shown in table are Stryker® model numbers 2 Contents in the validated Tray System included: Single-use implants (plates, meshes, bone screws, etc.), single-use instruments (drills), and reusable surgical instruments (benders, forceps, handles, depth gauges, trocars, etc.) 3 Tray system components part of the worst-case configuration in a full DIN Rigid Sterilization Container validation in an Aesculap SterilContainer Base (JK446) and Lid (JK489) cleared under K792558 4 Tray system components part of the worst-case configuration in a 1/2 DIN Rigid Sterilization Container validation in an Aesculap SterilContainer Base (JK346) and Lid (JK389) cleared under K792558 5 No lumened devices were validated within the tray system as part of the product load. The Stryker Universal Select Sterilization Tray System does not have any lumen claims.
Type of Use (Select one or both, as applicable)
Prescription Use (Part 21 CFR 801 Subpart D) X 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 thetime to review instructions, search existing data sources, gather and maintain the data needed and completeand review the collection of information. Send comments regarding this burden estimate or any other aspectof this information collection, including suggestions for reducing this burden, to:
Department of Health and Human ServicesFood and Drug AdministrationOffice of Chief Information OfficerPaperwork Reduction Act (PRA) [email protected]
“An agency may not conduct or sponsor, and a person is not required to respond to, a collection ofinformation unless it displays a currently valid OMB number.”
FORM FDA 3881 (7/17) Page 2 of 2 PSC Publishing Services (301) 443-6740 EF
DEPARTMENT OF HEALTH AND HUMAN SERVICESFood and Drug Administration
Indications for Use
Form Approved: OMB No. 0910-0120Expiration Date: 06/30/2020See PRA Statement below.
1 Tray System has been validated in the following Aesculap SterilContainer cleared for pre-vacuum steam sterilization under K792558: Full DIN JK444 (base) and JK489 (lid) and ½ DIN JK346 (base) and JK389 (lid)
The maximum validated product loads for the trays in containers are as follows:
Configuration1
Maximum Validated Load Set Contents2,5
3-Level Rack – Qty.
2
(29-13910) in a Full
DIN Rigid
Sterilization
Container3
29-12900 1.2 Upper-Face Plates/Screws Module with Lid (29-13941)
29-12901 1.2 Orbital Plates/Mesh Module with Lid (29-13941)
29-17900 1.7 Mid-Face Plates/Screws Module with Lid (29-13941)
29-17901 1.7 Mid-Face Plates Module with Lid (29-13941)
29-17903 1.7 Orthognathic Plates Inlay
29-13901 Upper-/Mid-Face Instrument Tray with Lid (29-13921)
29-13920 ¼ DIN Instrument/Accessory Tray with Lid (29-13921)
29-23900 2.0/2.3 Mandible Screws Module with Lid (29-13941)
29-23901 2.0/2.3 Mandible Plates Module with Lid (29-13941)
29-23905 2.0/2.3 Mini Plates Inlay, Large
29-13904 Mandible Fracture Instrument Tray with Lid (29-13921)
29-13905 Trocar Instrument Tray with Lid (29-13921)
3-Level Rack – Qty.
1
(29-13910) in a ½
DIN Rigid
Sterilization
Container4
29-23900 2.0/2.3 Mandible Screws Module with Lid (29-13941)
29-23903 2.0/2.3 Mandible Recon Plates Module with Lid (29-13941)
29-13904 Mandible Fracture Instrument Tray with Lid (29-13921)
29-13905 Trocar Instrument Tray with Lid (29-13921)
29-13906 Mandible Reconstruction Instrument Tray with Lid (29-13921)
29-13920 ¼ DIN Instrument/Accessory Tray with Lid (29-13921)
1 Model numbers shown in table are Stryker® model numbers 2 Contents in the validated Tray System included: Single-use implants (plates, meshes, bone screws, etc.), single-use
instruments (drills), and reusable surgical instruments (benders, forceps, handles, depth gauges, trocars, etc.) 3 Tray system components part of the worst-case configuration in a full DIN Rigid Sterilization Container validation in an
Aesculap SterilContainer Base (JK446) and Lid (JK489) cleared under K792558 4 Tray system components part of the worst-case configuration in a 1/2 DIN Rigid Sterilization Container validation in an
Aesculap SterilContainer Base (JK346) and Lid (JK389) cleared under K792558 5 No lumened devices were validated within the tray system as part of the product load. The Stryker Universal Select
Sterilization Tray System does have any lumen claims.
10. Technological Comparison: A detailed comparison of the subject device to the predicate device demonstrates the similarities and differences in intended use, design, principles of
operation, and materials of composition. The following pages contain a comparison of the
technological (Table 1) and performance (Table 2) characteristics of the subject and predicate
device.
Table 1: Comparison of Technological Characteristics
Predicate Device Subject Device
Device Name Medtronic Transportation/Sterilization
Cassettes Stryker Universal Select Sterilization Tray System