The Drive Rail System is intended to be used on adult or pediatric patients in the treatment of conditions of the long bones of the arms and legs including limb lengthening, acute or gradual multiplanar correction of long bone deformities, fractures and diseases which generally may result in joint contractures or loss of range of motion, fractures requiring distraction, open or closed fractures, non- unions, and infected fractures or non-unions.
Device Story
Drive Rail System is a unilateral external fixation system for orthopedic surgery on long bones of arms and legs. System comprises 316LVM stainless steel half pins and frame components (rail segments, pin clamps, distraction/compression devices) made of aluminum and stainless steel. Components are assembled into a frame tailored to specific patient anatomy. Device is used by surgeons in clinical settings to manage fractures, deformities, and limb lengthening. Worm gear component is made of 17-4 stainless steel, which is ferromagnetic, rendering the entire system MR Unsafe. Device is provided non-sterile and is for single use.
Clinical Evidence
No clinical data. The submission relies on scientific rationale regarding the presence of ferromagnetic materials to update MR safety labeling.
Technological Characteristics
Unilateral external fixation system. Materials: 316LVM stainless steel (half pins), aluminum and stainless steel (frame components), 17-4 stainless steel (worm gear). Principle: Mechanical fixation/distraction/compression. Form factor: Modular rail and clamp system. Connectivity: None. Sterilization: Provided non-sterile. MR status: MR Unsafe due to ferromagnetic worm gear.
Indications for Use
Indicated for adult and pediatric patients requiring treatment of long bone conditions of the arms and legs, including limb lengthening, multiplanar deformity correction, fractures (open/closed/requiring distraction), non-unions, and infected fractures/non-unions.
Regulatory Classification
Identification
Single/multiple component metallic bone fixation appliances and accessories are devices intended to be implanted consisting of one or more metallic components and their metallic fasteners. The devices contain a plate, a nail/plate combination, or a blade/plate combination that are made of alloys, such as cobalt-chromium-molybdenum, stainless steel, and titanium, that are intended to be held in position with fasteners, such as screws and nails, or bolts, nuts, and washers. These devices are used for fixation of fractures of the proximal or distal end of long bones, such as intracapsular, intertrochanteric, intercervical, supracondylar, or condylar fractures of the femur; for fusion of a joint; or for surgical procedures that involve cutting a bone. The devices may be implanted or attached through the skin so that a pulling force (traction) may be applied to the skeletal system.
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April 8, 2022
Image /page/0/Picture/1 description: The image shows 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 a blue square with the letters "FDA" in white. To the right of the blue square is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue.
OrthoPediatrics Corp. Yan Li Regulatory Affairs Manager 2850 Frontier Drive Warsaw, Indiana 46582
## Re: K220809
Trade/Device Name: Drive Rail System Regulation Number: 21 CFR 888.3030 Regulation Name: Single/Multiple Component Metallic Bone Fixation Appliances And Accessories Regulatory Class: Class II Product Code: KTT, JDW Dated: March 18, 2022 Received: March 21, 2022
# Dear Yan Li:
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. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. 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
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801); medical device reporting of medical device-related adverse events) (21 CFR 803) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4. Subpart A) for combination products; 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 https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.
For comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). 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 (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).
Sincerely,
Ting Song, Ph.D. Assistant Director DHT6A: Division of Joint Arthroplasty Devices OHT6: Office of Orthopedic Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health
Enclosure
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# Indications for Use
510(k) Number (if known) K220809
Device Name Drive Rail System
### Indications for Use (Describe)
The Drive Rail System is intended to be used on adult or pediatric patients in the treatment of conditions of the long bones of the arms and legs including limb lengthening, acute or gradual multiplanar correction of long bone deformities, fractures and diseases which generally may result in joint contractures or loss of range of motion, fractures requiring distraction, open or closed fractures, non- unions, and infected fractures or non-unions.
| Type of Use (Select one or both, as applicable) | |
|--------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------|
| <div> <span> <span style="text-decoration: overline;">☑</span> Prescription Use (Part 21 CFR 801 Subpart D) </span> </div> | <div> <span> <span style="text-decoration: overline;">☐</span> Over-The-Counter Use (21 CFR 801 Subpart C) </span> </div> |
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OrthoPediatrics, Corp. Drive Rail System Special 510(k)
Image /page/3/Picture/3 description: The image shows the logo for OrthoPediatrics. The logo is made up of a cartoon drawing of a child's face and body, with the word "Ortho" written in blue above the child's head. The word "Pediatrics" is written in red to the right of the child's head. The logo is simple and colorful, and it is likely intended to appeal to children and their parents.
# 3.0 510(k) Summary
#### I. Submitter
| Submission: | Special 510(k) Premarket Notification |
|------------------------------------|---------------------------------------|
| Applicant: | OrthoPediatrics Corp. |
| Applicant Address: | 2850 Frontier Drive, Warsaw, IN 46582 |
| Establishment Registration Number: | 3006460162 |
| Contact: | Yan Li |
| Contact Phone: | (574) 267-0864 |
| Date Prepared: | March 18, 2022 |
II. Device
| Device Trade Name: | Drive Rail System |
|-------------------------------|---------------------------------------------------------------------------------------------------------------|
| Regulation Number: | 21 CFR 888.3030 |
| Product Code and Common Name: | KTT: Appliance, Fixation, Nail/Blade/Plate<br>Combination, Multiple Component<br>JDW: Pin, Fixation, Threaded |
| Device Classification: | II |
| Classification Panel: | Orthopedic |
#### III. Predicate Device
Substantial equivalence is claimed to the following predicate devices:
Predicate: Drive Rail System, K140822, OrthoPediatrics Corp.
Note: K140822 was submitted by Devise Ortho Inc. in 2014, however, Devise Ortho Inc. was purchased by OrthoPediatrics Corp on April 20, 2021. OrthoPediatrics is the owner of K 140822 and the manufacturer of the Drive Rail System.
#### IV. Device Description
The Drive Rail System is a unilateral external fixation system that consists of various components used in the management of lower extremity bone fractures and reconstructive, as well as corrective, orthopedic surgery. The system consists of 316LVM stainless steel half pins along with frame components including rail segments, pin clamps, distraction/compression
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OrthoPediatrics, Corp. Drive Rail System Special 510(k)
Image /page/4/Picture/1 description: The image shows the text "K220809 - Page 2 of 3" at the top, followed by a logo for OrthoPediatrics. The logo features a stick figure with a smiley face and the company name in a stylized font. The stick figure is drawn in blue and green, while the company name is in blue and red.
devices and associated accessories made from aluminum and stainless-steel materials. These components should be combined to build a frame which is appropriate for each specific application. All half pins and frame components are single use devices and are provided nonsterile.
The worm gear component in the Drive Rail System is made of 17-4 stainless steel, which is ferromagnetic. Since the worm gear component is magnetic and is within each external rail construct, the Drive Rail System is MR unsafe.
#### V. Indications for Use
The Drive Rail System is intended to be used on adult or pediatric patients in the treatment of conditions of the long bones of the arms and legs including limb lengthening, acute or gradual multiplanar correction of long bone deformities, fractures and diseases which generally may result in joint contractures or loss of range of motion, fractures requiring distraction, open or closed fractures, non-unions, and infected fractures or non-unions.
#### VI. Comparison of Technological Characteristics
The OrthoPediatrics Drive Rail System and predicate devices share identical indications for use, device classification, product code. They are used in the same anatomical sites and have the same principle of operation, materials, sterilization, packaging, design and fundamental technological characteristics. The difference between the predicate device and the subject device is that the predicate device labeling states that "The Drive Rail System has not been evaluated for safety and compatibility in the MR environment. It has not been tested for heating, migration, or image artifact in the MR environment.", and the proposed labeling for the subject device is that "The Drive Rail System is MR Unsafe." as the component in the Drive Rail System contains ferromagnetic material.
#### VII. Performance Data
The purpose of this submission is to obtain clearance to label the Drive Rail System as "The Drive Rail System is MR Unsafe". When the Drive Rail System was cleared under K140822, the system has the labeling "The Drive Rail System has not been evaluated for safety and compatibility in the MR environment. It has not been tested for heating, migration, or image artifact in the MR environment."
According to page 23 and 24 of FDA's guidance "Testing and Labeling Medical Devices for Safety in the Magnetic Resonance (MR) Environment - Guidance for Industry and Food and Drug Administration Staff' issued on May 20, 2021. If the medical device contains ferromagnetic material(s), manufacturers cannot use the labeling of "Safety in MR environment not evaluated".
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Image /page/5/Picture/1 description: The image shows the text 'K220809 - Page 3 of 3'. The text is in a simple, sans-serif font and is left-aligned. The text indicates a document identifier and page number within a larger document.
Image /page/5/Picture/2 description: The image shows the logo for OrthoPediatrics. The logo features a cartoon drawing of a child's face with a smiling expression. The word "Ortho" is written in blue and is integrated into the cartoon drawing. The word "Pediatrics" is written in red and is located to the right of the word "Ortho".
According to page 10 of 36 of the FDA guidance "The Special 510(k) Program, Guidance for Industry and Food and Drug Administration Staff" issued on September 13, 2019, when addressing the question of Are performance data needed to evaluate the change? It states that "Verification and validation testing, however, may not be necessary to support SE. For example, FDA may receive a 510(k) from a manufacturer requesting clearance to label their device as Magnetic Resonance (MR) Unsafe after previously labeling their device as 'Safety in MR Imaging Not Evaluated.' As discussed in the FDA guidance document Establishing Safety and Compatibility of Passive Implants in the Magnetic Resonance (MR) Environment, MR Unsafe labeling is based on a scientific rationale and does not involve any performance data."
Therefore, OrthoPediatrics Corp reviewed drawings and conducted test to determine of component in the system contains ferromagnetic materials and is magnetic.
# VIII. Conclusion
The information provided above supports that the Drive Rail System is as safe and effective as the predicate device. Information provided within the submission support the differences between the subject and predicate devices and support the labeling change. Therefore, it is concluded that the Drive Rail System is substantially equivalent to the predicate devices.
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Learn the FDA Browser
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.