Patient Specific Talus Spacer

 Additive Orthopaedics

INDICATION FOR USE: For avascular necrosis of the ankle joint. The anatomical landmarks necessary for the design and creation of the Additive Orthopaedics Patient Specific Talus Spacer must be present and identifiable on computed tomography scan.

ADDRESSING UNMET NEED: Avascular necrosis is a rare, serious and potentially debilitating that can cause removal of part of leg; provides patients with treatment option that could potentially reduce pain, retain range of motion of joint and improve quality of life

DECRIPTION: Additively manufactured implant made from cobalt chromium metal alloy and produced by laser sintering

  • Made for each patient individually, modeled from computed tomography (CT) imaging, and is fitted to a patient’s specific anatomy
  • During replacement surgery, patient’s talus bone is removed and replaced with implant made from cobalt chromium alloy
  • Intended to be a joint-sparing procedure, as it allows the patient to retain motion in the ankle joint

SAFETY AND PROBABLE BENEFIT:

  • Results from 31 patients and 32 talus replacement surgeries (one patient had operations on both ankles) with the implant
  • Probable benefit endpoint: Reduction in baseline level pain following surgery using the Visual Analog Scale (“VAS”) + ankle range of motion (“ROM”), Foot and Ankle Outcome Scores (“FAOS”) and FAOS subscales on activities of daily living (“ADL”), ability to perform sports and recreational activities, QoL
  • Primary safety endpoint: Secondary subsequent surgical intervention (“SSSI”) + adverse events
  • At three years post-operation, the average reported pain decreased from “moderate to severe” prior to surgery to “mild” post-surgery, and average range of motion in the ankle joint also improved
  • By the three-year mark, 3 reported additional surgeries
  • The most common reported adverse events were pain and scar tissue at the surgery site

REGULATORY PATHWAY: Humanitarian Device Exemption

  • Trade/Device Name: Patient Specific Talus Spacer
  • Product Code: QNN
  • Annual Report requirements
  • Post-approval study: Patient Specific Talus Spacer Registry PAS is a prospective post-approval US registry study to provide ongoing safety and probable benefit assessment

LABELING

Gili Pro BioSensor

ContinUse Biometrics Ltd.

INDICATION FOR USE: Includes an optical module that is intended to capture motion-vibration signals from an illuminated surface for assessment of physiological information. Such information, captured during spot-measurement, includes: Heart rate, Respiratory rate

The device is indicated for use by or under the supervision of healthcare professionals for adult patients in a hospital, outpatient, or other medical care settings, or for clinical research purposes. The device should be used while the subject is seated upright either in a chair or in a bed. The information stored on the system may be reviewed by qualified persons.

DEVICE TYPE: Hardware and software for optical camera-based measurement of pulse rate, heart rate, breathing rate, and/or respiratory rate.

  • The device uses an optical sensor system and software algorithms to obtain and analyze video signal and estimate pulse rate, heart rate, respiratory rate and/or breathing rates.
  • Not intended to independently direct therapy

CLINICAL DATA:

  • Representative of the intended use population for the device
  • Demonstrate output consistency using the expected range of data sources and data quality encountered in the intended use population and environment
  • Compare device output with a clinically accurate patient-contacting relevant comparator device in an accurate and reproducible manner

RISKS:

  • Delayed or incorrect treatment due to erroneous output as a result of device malfunction or algorithm error
  • Delayed or incorrect treatment due to user misinterpretation
  • Eye damage, burns, and related safety concerns due to illuminating optics

REGULATORY PATHWAY: De Novo request

  • Regulation Number: 21 CFR 870.2790
  • Regulation Name: Hardware and software for optical camera-based measurement of pulse rate, heart rate, breathing rate, and/or respiratory rate
  • Regulatory Class: Class II
  • Product Code: QOK

RECLASSIFICATION ORDER

GI Genius

Cosmo Artificial Intelligence – AI, LTD /Medtronic

INDICATION FOR USE: Computer-assisted reading tool designed to aid endoscopists in detecting colonic mucosal lesions (such as polyps and adenomas) in real time during standard white -light endoscopy examinations of patients undergoing screening and surveillance endoscopic mucosal evaluations. The GI Genius computer-assisted detection device is limited for use with standard whitelight endoscopy imaging only. This device is not intended to replace clinical decision making.

DEVICE TYPE: Gastrointestinal lesion software detection system

  • Computer-assisted detection device used in conjunction with endoscopy for the detection of abnormal lesions in the gastrointestinal tract. This device with advanced software algorithms brings attention to images to aid in the detection of lesions. The device may contain hardware to support interfacing with an endoscope

CLINICAL DATA:

  •  Demonstrate that device performs as intended under anticipated conditions of use, including detection of gastrointestinal lesions and evaluation of all adverse events

RISKS:

  • Algorithm failure leading to – False positives resulting in unnecessary patient treatment; or False negatives resulting in delayed patient treatment
  • Failure to identify lesions, resulting in delayed patient treatment, due to software/hardware failure including: Incompatibility with hardware and/or data source, Inadequate mapping of software architecture, Degradation of image quality, Prolonged delay of real-time endoscopic video

REGULATORY PATHWAY: De Novo request

  • Regulation Number: 21 CFR 876.1520
  • Regulation Name: Gastrointestinal lesion software detection system
  • Regulatory Class: II
  • Product Code: QNP

RECLASSIFICATION ORDER

IpsiHand Upper Extremity Rehabilitation System

Neurolutions Inc

INDICATION FOR USE: For use in chronic stroke patients (≥ 6 months post-stroke) age 18 or older undergoing stroke rehabilitation, to facilitate muscle re-education and for maintaining or increasing range of motion in the upper extremity.

DEVICE TYPE: Electroencephalography (EEG)-driven upper extremity powered exerciser

  • An EEG-driven upper extremity powered exerciser is a non-invasive prescription device intended for rehabilitation by driving movement or exercise of an impaired upper extremity in response to the detection of purpose oriented electrical activity produced by the patient’s brain

CLINICAL DATA:

  • Unblinded study of 40 patients over a 12-week trial
  • All participants demonstrated motor function improvement with the device over the trial
  • Adverse events reported included minor fatigue and discomfort and temporary skin redness 

RISKS:

  • Device provides ineffective treatment, leading to worsening condition
  • Unintended motion leading to injury
  • Thermal injury including burns and shock
  • Adverse tissue reaction
  • Cross contamination, leading to infection or adverse tissue reaction
  • Pain or discomfort including: Headache, Fatigue, Skin redness

REGULATORY PATHWAY: De Novo request, Breakthrough designation

  • Regulation Number: 21 CFR 890.5420
  • Regulation Name: Electroencephalography (EEG)-driven upper extremity powered exerciser
  • Regulatory Class: Class II
  • Product Code: QOL

RECLASSIFICATION ORDER


Image credit: Respective device manufacturers