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U.S. Department of Health and Human Services

510(k) Premarket Notification

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Device Classification Name Prosthesis, Shoulder, Semi-Constrained, Metal/Polymer, Uncemented
510(k) Number K173824
Device Name Humeral Short Stem System
Applicant
Shoulder Innovations, Inc.
13827 Port Sheldon St.
Holland,  MI  49424
Applicant Contact Don Running
Correspondent
Shoulder Innovations, Inc.
13827 Port Sheldon St.
Holland,  MI  49424
Correspondent Contact Don Running
Regulation Number888.3670
Classification Product Code
MBF  
Subsequent Product Codes
HSD   KWS   KWT  
Date Received12/18/2017
Decision Date 10/23/2018
Decision Substantially Equivalent (SESE)
Regulation Medical Specialty Orthopedic
510k Review Panel Orthopedic
Summary Summary
Type Traditional
Reviewed by Third Party No
Combination Product No
Predetermined Change
Control Plan Authorized
No
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