Food and Drug Administration 5 10(k) Notijfication - Partial & Total Ossicular Replacement Prostheses AUG I 8 2006 June 30, 2006



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5 10(k) Notijfication - Partial & Total Ossicular Replacement AUG I 8 2006 510(K) SUMMARY OF SAFETY AND EFFECTIVENESS Grace Medical Adjustable Length and Fixed Length Partial and Total Ossicular Replacement Trade Name: The family of Grace Medical Adjustable and Fixed Length Partial & Total Ossicular Replacement consists of: * Grace Medical ALTO (Adjustable Length Total Ossicular) * Grace Medical ALPO (Adjustable Length Partial Ossicular) * Grace Medical FLTO (Fixed Length Total Ossicular) * Grace Medical FLPO (Fixed Length Partial Ossicular) * Silverstein ALTO (Adjustable Length Partial Ossicular) with Footplate Tack * Grace Medical Frisbee Myringopexy (Fixed Length Partial Ossicular) Common Name: Partial Ossicular Replacement Total Ossicular Replacement Classification Name: Partial Ossicular Replacement (CFR 21 874.3450) Total Ossicular Replacement (CFR 21 874.3495) Official Contact: Jeff Cobb Vice President of Regulatory Affairs & Quality Grace Medical, Inc. 8500 Wolf Lake Drive, Suite 110 Memphis, TN 38133 Telephone: (901) 380-7000 Telefax: (901) 380-7001 Date Prepared: Predicate Devices - The Grace Medical Adjustable Length and Fixed Length Partial and Total Ossicular are substantially equivalent to the predicate devices listed below. 510(k) Number Predicate Device Manufacturer (if known) BELL (Various Models) Heinz Kurz GmbH K972492 AERIAL (Various Models) Heinz Kurz GmbH K972585 Length-Adjustable Partial (BELL Vario) and Total Heinz Kurz GmnbH K990923 (AERIAL Vario) Ossicular Smith & Nephew PORP & TORP Gymus ENT K002737 Smith & Nephew Off-Centered PORP GymusENT K002464 Gyms ENT Brackman Modified TORI' GymusENT Intended Use - The Grace Medical Adjustable Length and Fixed Length Partial & Total Ossicular Replacement have the sane primary intended use as the predicate devices. An ossicular replacement prosthesis is a device intended to be implanted for the functional reconstruction of segments of the ossicular chain and facilitates the conduction of sound wave from the tympanic membrane to the inner ear. Page 14

510(k) Notification - Partial & Total Ossicular Replacement Ossicular replacement prostheses are indicated for the functional restoration of the ossicular chain when a conductive hearing loss is present. Indications for use include: Chronic middle ear disease, Otosclerosis, Congenital fixation of the stapes, Secondary surgical intervention to correct for a significant and persistent conductive hearing loss from prior otologic surgery, and surgically correctible injury to the middle ear from trauma. Materials - The Grace Medical Adjustable Length and Fixed Length Partial & Total Ossicular Replacement are manufactured from the same or similar materials as the predicate devices. The Grace Medical Adjustable-Length PORP's and TORP's contain a medical grade silicone sleeve fixed to the titanium shaft which allows for adjustment to length by the user. Design Features - Various designs of Grace Medical Adjustable Length and Fixed Length Partial & Total Ossicular Replacement are available to meet physician preference. The design features of the Grace Medical Adjustable Length and Fixed Length Partial & Total Ossicular Replacement raise no new safety or effectiveness issues. Page 15

510(k) Notification - Partial & Total Ossicular Replacement Comparison Charts GRACE GRACE BELL AERIAL VARIO SMITH & SMITH & GYRus ENT MEDICAL MEDICAL PROSTHESES PROSTHESES LENGTH- NEPHEW NEPHEW OFF- BRACKMAN ADJUSTABLE PARTIAL & KURZ KURZ ADJUSTABLE PORP & CENTERED MODIFIED LENGTH AND TOTAL (1972492) (1972585) PROSTHESES TORP PORP TORP FIXED LENGTH PROSTHESES KURZ GyRus ENT GYRus ENT GYRUS ENT POREPS & TORPS ({972815) (K990923) (K002737) K002464) (KXxxxxx) Intended Total and Partial Total Partial Partial Total Total and Total and Partial Total Use Reconstruction Reconstruction Reconstruction Reconstruction Partial Partial Reconstruction Reconstruction of the Ossicular of the Ossicular of the of the Reconstruction Reconstruction of the Ossicular of the Chain Chain Ossicular Ossicular of the Ossicular of the Ossicular Chain Ossicular Chain Chain Chain Chain Chain Head Titanium Titanium Titanium Titanium Titanium Titanium Hydroxylapatite Plasti-pore Material(s) (Titanium Alloy) (Titanium (Titanium Alloy) Alloy) Hydroxylapatite (HA) Hydroxylapatite HA-Coated Ti Stainless Steel Otosil ( w/ BaSO 4 ) Polyethylene PTFE Stainless Steel Shaft Titanium Titanium Titanium Titanium Titanium Titanium Titanium Plastipore w/ Material(s) (Titanium Alloy) (Titanium (Titanium (Titanium wire Alloy) Alloy) Alloy) Ti w/ Sleeve Polyethylene PTFE Stainless Steel PTFE Polyethylene Head Shape Circular Circular Circular Circular Circular Circular Oval Round Semi-circular Oval Oblong Trapezoidal Oval Notched Notched Functional Fixed Sizes from 4.0 to 8.0 1.75 to 4.50 3.0 to 7.0 Adjustable 2.0 to 9.0 Unknown 8nam Length 0.5 to 9.0 model - Trimmable (mm) Trimmed to Adjustable length model- Intraoperatively TORPs are Trimmed to Trimmed to length length - I lntraoperatively Ilntraoperatively How Sterile Sterile Sterile Sterile Sterile Sterile Sterile Sterile Supplied I I I I I I Differences between the Grace Medical Modified Partial Ossicular Replacement and the predicate devices should not raise new issues regarding safety or effectiveness. Page 16

S~~~~~~tV~~~~~~~~Ca 0 ~~~~~~~~Public Health Service DEPARTMENT OF HEALTH & HUMAN SERVICES AUG 1 8 2006 Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850 Grace Medical, Inc. c/o Mr. Jeff Cobb 8500 Wolf Lake Dr., Suite 110 Memphis, TN 38133 Re: K061853 Trade/Device Name: Grace Medical Adjustable and Fixed Length Partial & Total Ossicular Replacement Regulation Number: 21 CFR 874.3450 Regulation Name: Partial Ossicular Replacement ; Total Ossicular Replacement Regulatory Class: II Product Code: ETB; ETA Dated: Received: July 18, 2006 Dear Mr. Cobb: 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. If your device is classified (see above) into either class IL (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.

Page 2 - Mr. Jeff Cobb This letter will allow you to begin marketing your device as described in your Section 5 10(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 (240) 276-0115. 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 (800) 638-2041 or (240) 276-3150 or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html. Sincerely yours, Malvina B 'Edelman, M.D. Director Division of Ophthalmic and Ear, Nose and Throat Devices Office of Device Evaluation Center for Devices and Radiological Health Enclosure

510(k) Notification - Partial & Total Ossicular Replacement 510(k) Number: K C"33 (961 Device Name: The family of Grace Medical Adjustable and Fixed Length Partial & Total Ossicular Replacement consists of: * Grace Medical ALTO (Adjustable Length Total Ossicular) * Grace Medical ALPO (Adjustable Length Partial'Ossicular) * Grace Medical FLTO (Fixed Length Total Ossicular) * Grace Medical FLPO (Fixed Length Partial Ossicular) * Silverstein ALTO (Adjustable Length Partial Ossicular) with Footplate Tack * Grace Medical Frisbee Myringopexy (Fixed Length Partial Ossicular) a) Indications for Use An ossicular replacement prosthesis is a device intended to be implanted for the functional reconstruction of segments of the ossicular chain and facilitates the conduction of sound wave from the tympanic membrane to the inner ear. Ossicular replacement prostheses are indicated for the functional restoration of the ossicular chain when a conductive hearing loss is present. Indications for use include: (a) Chronic middle ear disease, (b) Otosclerosis, (c) Congenital fixation of the stapes, (d) Secondary surgical intervention to correct for a significant and persistent conductive hearing loss from prior otologic surgery, and (e) Surgically correctible injury to the middle ear from trauma. (PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH-, Office of Device Evaluation (ODE) Prescription Use X OR Over-The-Counter Use (Per 21 CFR 801.109) (Optional Format 1-2/96) Division of Ophthalmic Ear, Nose an l'nrofi Lev1ss Page 3