The prostheses are intended for partial ossicular replacement to restore functionality to the middle ear in cases of pathological changes of the sound transmission system. The NiTiBOND Stapes Prosthesis act as a bridge between the long process of the incus and the base of the stapes, with the piston extending into the perilymphatic space of the inner ear. The loop consists of a nickel-titanium alloy (Nitinol), while the piston is made of pure titanium. Specifically, the devices are designed for the treatment of 1. Otosclerosis (stapedial fixation) / congenital stapedial fixation 2. Traumatic injury to the ossicular chain 3. Malformation of the middle ear 4. Revision surgery to correct inadequate hearing improvement, e.g. through dislocation of a prosthesis
Device Story
Stapes prosthesis for middle ear reconstruction; bridges incus to stapes base; piston extends into perilymphatic space. Composed of Nitinol loop and pure titanium shaft. Loop features 'ContactFree Zones' to limit heat dispersion and prevent incus strangulation. Operated by surgeon in clinical setting; heat applied to Nitinol loop to induce shape memory closure. Includes 'Thermo-Dummy' accessory for pre-operative laser setting calibration. Restores sound transmission functionality; benefits patients with conductive hearing loss.
Clinical Evidence
No clinical trials conducted. Substantial equivalence supported by non-clinical bench testing (coupling effectiveness, sound transmission stability, MRI compatibility, biocompatibility, shelf life, sterilization/packaging validation) and reference to published literature indicating post-operative hearing improvement comparable to legally marketed devices.
Indicated for patients requiring partial ossicular replacement due to otosclerosis, congenital stapedial fixation, traumatic ossicular chain injury, middle ear malformation, or revision surgery for prosthesis dislocation.
Regulatory Classification
Identification
A partial 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. The device is made of materials such as stainless steel, tantalum, polytetrafluoroethylene, polyethylene, polytetrafluoroethylene with carbon fibers composite, absorbable gelatin material, porous polyethylene, or from a combination of these materials.
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Page 1 of 4
FEB 8 2013
## 510(k) SUMMARY of Safety and Effectiveness
As required by CFR Section 807.92(c)
1. Submitter [807.92 (a)(1)] Heinz Kurz GmbH Medizintechnik Tübinger Str. 3 D-72144 Dusslingen Germany +49-7072-91 79 0 Tel. Fax +49-7072-91 79 79 Email info@kurzmed.de
#### 2. Submission Correspondent [807.92 (a)(1)] Dagmar Mäser Business Support International V.O.F. Amstel 320-l 1017 AP Amsterdam The Netherlands1 +31-20-428 95 91 Tel. + 1-828-622-7572 Tel. Fax +31-20-201-0175 Email bsi@xs4all.nl
- 3. Date Summary Prepared [807.92 (a)(1)] February 4, 2012
- 4. Reason for Submission [807.92(3)(i)] New Device
| 5. Device Names | [807.92 (a)(2)] |
|-----------------|-------------------------------------------|
| Proprietary | NiTiBOND Stapes Prosthesis |
| Common | Stapes Prosthesis, Stapes Piston |
| Classification | Prosthesis, Partial Ossicular Replacement |
| Product Code | 77 ETB |
| Regulation # | CFR 874.3450 |
- 6. Predicate Devices [807.92(a)(3)] K003214 SMart Piston - GYRUS ENT L.L.C K063374 Eclipse Nitinol Locking Piston - GRACE MEDICAL, INC K021479 CliP® Piston áWengen - HEINZ KURZ GMBH
<sup>1</sup> NC Address: BSI, 271 Waldroup Road, PO Box 457, Hot Springs, NC 28743
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#### 7. Device Description [807.92(a)(4)]
The stapes prosthesis consists of a Nitinol loop and the standard KURZ shaft made of pure titanium (ASTM F67).
The flat loop band diffuses the impact of pressure on the incus. When applying heat to the ContactFree Zones, the shape memory features of Nitinol cause the loop to close. The ContactFree Zones serve as heat blockers, limit heat dispersion on the mucosa and minimize the risk of incus stranqulation. The prosthesis comes with an accessory, the Thermo-Dummy®, to predetermine the lowest laser setting that will close the prosthesis loop outside the patient's ear before inserting the implant.
#### 8. Statement of Intended Use [807.92(a)(5)]
The prosthesis is intended for ossicular replacement to restore functionality to the middle ear in cases of pathological changes of the sound transmission system. The NiTiBOND Stapes Prosthesis acts as a bridge between the long process of the incus and the base of the stapes, with the piston extending into the perilymphatic space of the inner ear.
The prosthesis consists of a nickel-titanium alloy (Nitinol) loop and a pure titanium piston (ASTM F67).
Specifically, the device is designed for the treatment of
- (1) Otosclerosis (stapedial fixation) / congenital stapedial fixation
- (2) Traumatic iniurv to the ossicular chain
- (3) Malformation of the middle ear
- (4) Revision surgery to correct inadequate hearing improvement, e.g. through dislocation of a prosthesis
#### 9. Performance Data [807.92(b)]
#### (i) Non-Clinical Performance Tests [807.92(b)(1)]
The performance specifications were met. The following tests were conducted:
- Coupling Effectiveness .
- Stability of Coupling during Sound Transmission .
- MRI Environment .
- Biocompatibility .
- . Shelf Life Testing
- Sterilization Validation .
- Packaging Validation .
#### (ii) Clinical Evaluation [807.92(b)(2)]
According to published literature, post-operative hearing improvement is substantially equivalent when compared to legally marketed SE devices.
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Page 3 of 4
| | NITIBOND<br>Stapes Prosthesis | SMart Piston | Eclipse<br>Nitinol Piston | CliP® Piston<br>áWengen |
|-------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------|-----------------------------------|--------------------------------------------|
| Device | Heinz KURZ GmbH | GYRUS ACMI -<br>Olympus | GRACE Medical Inc. | Heinz KURZ<br>GmbH |
| | K112616 | K003214 | K063374 | K021479 |
| Design<br>Comparison | Image: NITIBOND Stapes Prosthesis | Image: SMart Piston | Image: Eclipse Nitinol Piston | Image: CliP® Piston áWengen |
| Intended Use | The prosthesis is<br>intended for ossicular<br>replacement to restore<br>functionality to the<br>middle ear in cases of<br>pathological changes<br>of the sound<br>transmission system. | Identical | Identical | Identical |
| Method of<br>Attachment | Heat Application | Heat Application | Heat Application | Manual |
| # of Sizes | 16 (8 for each Ø) | 15 (5 for each Ø) | 12 (6 for each Ø) | 16 (8 for each Ø) |
| Dimensions<br>Length<br>[mm] | 3.5 - 5.5<br>(0.25 mm intervals) | 3.75 - 4.75<br>(0.25 mm intervals) | 3.75 - 5.0<br>(0.25 mm intervals) | 3.5 - 5.5<br>(0.25 mm intervals) |
| Piston Ø<br>[mm] | 0.4 / 0.6 | 0.5 / 0.6 / 0.8 | 0.5 / 0.6 | 0.4 / 0.6 |
| Width of<br>Loop Band<br>[mm] | 0.25 | Wire | Wire | 0.25 |
| Materials<br>Loop<br>Piston | Nitinol<br>Titanium (ASTM F67) | Nitinol<br>Fluoroplastic | Nitinol<br>Fluoroplastic | Titanium (ASTM F67)<br>Titanium (ASTM F67) |
| Single Use | Yes | Yes | Yes | Yes |
| Sterile | Yes | Yes | Yes | Yes |
| MRI | MR Conditional<br>1.5, 3 + 7 Tesla | MR Conditional<br>3 Tesla or less | MR Conditional<br>3 Tesla or less | MR Conditional<br>1.5, 3 + 7 Tesla |
| Biocompatible | Yes | Yes | Yes | Yes |
| Accessory | Thermo-Dummy® to<br>determine laser<br>setting for closing the<br>loop outside the<br>patient's ear prior to<br>implant insertion | No | No | Not Applicable |
### 10. Comparison with Predicate Devices [807.92(a)(6)]
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Page 4 of 4
### 11. Information Bearing on Device Safety and Effectiveness [807.92 (b)(3)]
[807.92 (b)(3)]
The differences between the KURZ NiTiBOND Stapes Prosthesis and the predicate devices are designed to enhance the safety and effectiveness of stapedotomy procedures.
Nonclinical and clinical testing demonstrate that the KURZ NiTiBOND is as safe and effective as the predicate devices.
There are no known characteristics that would introduce adverse effects.
The results of non-clinical and clinical design and performance validations raise no new issues of safety and effectiveness.
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Image /page/4/Picture/1 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo features a stylized eagle with three stripes forming its body and wing. The eagle is facing to the right. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES-USA" is arranged in a circular pattern around the eagle.
#### Public Health Service
Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609 Silver Spring, MD 20993-0002
February 8, 2013
Heinz Kurz GmbH Medizintechnik % Ms. Kristina Bitzer Manager Regulatory Affairs Maeser Support International, V.O.F. Amstel 320-1 Amsterdam Neitherlands
Re: K112616
Trade/Device Name: NitiBond Stapes Prosthesis Regulation Number: 21 CFR 874.3450 Regulation Name: Partial Ossicular Replacement Prosthesis Regulatory Class: Class II Product Code: ETB Dated: January 28, 2013 Received: February 6, 2013
#### Dear Ms. Bitzer:
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.
{5}------------------------------------------------
Page 2 - Ms. Kristina Bitzer
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 (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.
If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please go to http://www.fda.gov/AboutFDA/CentersOffices/CDRH/CDRHOffices/ucm115809.htm for the Center for Devices and Radiological Health's (CDRH's) Office of Compliance. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR 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.
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 (301) 796-7100 or at its Internet address
http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm.
Sincerely yours,
**Eric A. Mann** for
Malvina B. Eydelman, M.D. Director Division of Opthalmic and Ear, Nose, and Throat Devices Center for Devices and Radiological Health
Enclosure
{6}------------------------------------------------
# Indications for Use
510(k) Number (if known): K112616
Device Name:
KT12979
NiTiBOND Stapes Prosthesis
Indications for Use:
The prostheses are intended for partial ossicular replacement to restore functionality to the middle ear in cases of pathological changes of the sound transmission system. The NiTiBOND Stapes Prosthesis act as a bridge between the long process of the incus and the base of the stapes, with the piston extending into the perilymphatic space of the inner ear.
The loop consists of a nickel-titanium alloy (Nitinol), while the piston is made of pure titanium.
Specifically, the devices are designed for the treatment of
- Otosclerosis (stapedial fixation) / congenital stapedial fixation 1.
- 2. Traumatic injury to the ossicular chain
- 3. Malformation of the middle ear
- Revision surgery to correct inadequate hearing improvement, e.g. through dislocation 4. of a prosthesis
Prescription Use X (Part 21 CFR 801 Subpart D)
AND/OR
Over-The-Counter Use (21 CFR 801 Subpart C)
(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE OF NEEDED)
| Concurrence of CDRH, Office of Device Evaluation (ODE) | |
|--------------------------------------------------------|--|
|--------------------------------------------------------|--|
| Prescription Use | X |
|----------------------|---|
| (Per 21 CFR 801.109) | |
| (Division Sign-Off) | |
|---------------------------------------------------------|---------|
| Division of Ophthalmic and Ear, Nose and Throat Devices | |
| 510(k) Number | K112616 |
| Page 1 of 1 | |
|-------------|--|
|-------------|--|
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Two short videos show you everything — or skip straight to the written tutorial if you'd rather read. You can reopen this any time from the Tutorial button in the top bar.
Part 1 — Search, results, and everyday workflows 16 min
Part 2 — Embeddings: the galaxy map 3 min
1. Search: exact and fuzzy
Type a phrase like "coronary artery calcification" into the search box. You get two kinds of results. Exact results match the literal phrase — prefix searches work ("coronary artery calcificati") but suffix searches do not. Fuzzy results match on the meaning and intent of your phrase rather than the exact words, and are sorted by relevance score. Hover over the Exact or Fuzzy badge on any row to see exactly why it matched.
Use the checkboxes above the results to narrow: SaMD keeps only software-only devices, AI / ML keeps only devices with AI.
Exact vs. fuzzy search: what's the difference?
Exact matches on the literal phrase (prefix search works, suffix does not). Fuzzy matches on the meaning and intent of the phrase rather than the exact words. Hover over the badge on any row to see why it matched.
You search "coronary artery calcification" and want only software devices with AI. What two filters do you apply?
Narrow by SaMD (software-only devices), then narrow by AI/ML (devices with AI).
2. The results table
Scroll right in the results table. The intended use is extracted for you — no need to open the PDF. The device story gives a high-level snapshot of what the device does and how it's used. The AI Performance sub-table shows each output name, acceptance criteria, observed values, and development/test dataset descriptions — the same format Innolitics uses for regulatory strategy outputs, and the fastest high-level fingerprint of an AI device. It is AI-generated but has been very reliable in practice.
Where do you find a device's intended use without opening the PDF?
Scroll right in the search results table. The intended use column is extracted for you; no need to dig into the 510(k) summary PDF.
What does the AI Performance sub-table show, and why is it useful?
Output name, acceptance criteria, observed values, development dataset description, and test dataset description. It's the same format we use for regulatory strategy output and Fast 510(k) input, and the fastest high-level fingerprint of an AI device. AI-generated but reliable in practice.
3. Judging fuzzy relevance
Fuzzy results trail off in relevance as you scroll. Use three signals to decide how far down to go: the fuzzy badge explanations, the intended use column, and whether your target output (e.g., Cobb angle) still appears in the AI Performance sub-table. Once it stops appearing, you're past the relevant zone. A top hit with a low score (~0.4) and a stretched explanation is a hint the closest predicates are far away — the project may be headed for De Novo. Note the fuzzy search is a pattern match: it doesn't handle negation ("not") well, and hardware devices can appear — filter by SaMD/AI ML to cut them.
How do you judge how far down fuzzy search results to go?
Use the relevancy signals: the fuzzy badge explanations, the intended use column, and whether the target output (e.g., Cobb angle) still appears in the AI Performance sub-table. Once it stops appearing, results are trailing off in relevancy.
4. Device detail page: chat and citations
Click a device name to open its detail page: device facts on the left, a chat window on the right. Ask something like "Describe the training data". The answer carries little citation bubbles — click one to jump to the highlighted passage in the source PDF, so you can verify every AI answer against the document. There's also a Download PDF button for sharing.
How do you verify an AI chat answer on the device detail page?
Click the citation bubbles to jump to the relevant highlight in the source document.
Reading rule for every project: how many summaries do you read in full?
At least the three most relevant 510(k) or De Novo summaries, in full. After that, use targeted chat questions to confirm your memory quickly. The tool supports this professional habit — it doesn't replace it.
5. Side-by-side comparison
Select multiple rows in the results table (aim for under ~10), then open the PDF Viewer tab. Ask one question — it goes to all selected devices in parallel, each with citations. This is the fastest way to compare and contrast devices: training data, PCCP scope, how they handled adding new scanners, and so on.
What does the side-by-side PDF viewer mode do?
Select multiple devices, open the PDF viewer tab, and ask one question (e.g., "Describe the training data"). It queries all selected devices simultaneously with citations, so you can compare and contrast quickly.
6. Collections
With rows selected, go to the Collections tab and create a labeled collection (e.g., "Cobb Angle Project"). Reload that selection any time — before a client call, pull up the collection and ask questions across all of its devices at once.
How do you save a set of selected devices for later use?
Select the rows, go to the Collections tab, and create a labeled collection (e.g., "Cobb Angle Project"). You can reload the selection anytime and carry it into the PDF viewer and other tabs that support selections.
7. Product codes and the regulations tree
Click a product code in the results to jump to it in the regulations tree — identification text, sibling product codes, and devices you can open in a PDF viewer on the right. Click a regulation number to see its identification, special controls, and related product codes. You can also search by product code or regulation number at the top of the tree. Always read the special controls if any exist for your device — it broadens your search and sharpens pre-kickoff research.
What can you do from the regulations tree view?
Browse product codes and regulation numbers, read the identification text and special controls, browse sibling product codes, open device PDFs on the right, and search by product code or regulation number at the top of the tree.
8. Chart view
Click Show Chart and segment by regulation number (or product code) to see which regulations dominate your result set. Clicking a regulation takes you into the regulations tree. Great for spotting that most matches are, say, hardware laparoscopic devices — a cue to go back and filter.
How do you see which regulations dominate a search result set?
Click "Show Chart" and segment by Regulation Number. Clicking a regulation takes you to the regulations tree.
9. The predicate graph
Open the Predicates tab for a family-tree view of predicate relationships. Click a node to trace its parents and children; selections from search carry over pre-selected. Commonly predicated devices are worth reading — a lot of people predicated them for a reason. The visual lineage is also handy on client calls, e.g. to show how a predicate family evolved and justify why your predicate still holds.
In the predicate graph, why are commonly predicated devices worth reading?
A lot of people predicated them for a reason. Clicking a node traces parents and children, and selections from search carry over pre-selected.
10. Embeddings: the galaxy map
The Embeddings tab plots every matching document in a 2-D "galaxy map" where semantically similar devices cluster together. Hover or click clusters to explore, and let AI label the clusters for you. Embeddings beat product codes for grouping: two devices can carry different product codes (LLZ vs. QIH) yet do the same thing — the embedding captures the meaning of the intended use and device story. This is also exactly how retrieval-augmented generation (RAG) works under the hood, and it makes a great visual on client calls.
Try it yourself
Head to the search page and work through a few of these AI/ML fuzzy searches to build intuition: perivascular fat on CT · aortic valve calcification opportunistic screening on noncontrast CT · breast cancer prediction on digital pathology slides · autism detection · gestational age prediction · a hearing aid that can also detect a pulse · foundation model based analysis of ECG · large language models · penetration test. Watch how the relevance scores, intended use, and AI Performance tables tell you when results stop being meaningful.