Rule2026-11302

Medical Devices; Orthopedic Devices; Classification of the Absorbable Metallic Bone Fixation Fastener

Primary source

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Published
June 5, 2026
Effective
June 5, 2026

Issuing agencies

Health and Human Services DepartmentFood and Drug Administration

Abstract

The Food and Drug Administration (FDA) is classifying the absorbable metallic bone fixation fastener into class II (special controls). The special controls that apply to the device type are identified in this order and will be part of the codified language for classification of the absorbable metallic bone fixation fastener. We are taking this action because we have determined that classifying the device into class II will provide a reasonable assurance of safety and effectiveness of the device. We believe this action will also enhance patients' access to beneficial innovative devices, in part by reducing regulatory burdens.

Full Text

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<title>Federal Register, Volume 91 Issue 108 (Friday, June 5, 2026)</title>
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[Federal Register Volume 91, Number 108 (Friday, June 5, 2026)]
[Rules and Regulations]
[Pages 34146-34148]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2026-11302]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Food and Drug Administration

21 CFR Part 888

[Docket No. FDA-2026-N-5962]


Medical Devices; Orthopedic Devices; Classification of the 
Absorbable Metallic Bone Fixation Fastener

AGENCY: Food and Drug Administration, HHS.

ACTION: Final amendment; final order.

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SUMMARY: The Food and Drug Administration (FDA) is classifying the 
absorbable metallic bone fixation fastener into class II (special 
controls). The special controls that apply to the device type are 
identified in this order and will be part of the codified language for 
classification of the absorbable metallic bone fixation fastener. We 
are taking this action because we have determined that classifying the 
device into class II will provide a reasonable assurance of safety and 
effectiveness of the device. We believe this action will also enhance 
patients' access to beneficial innovative devices, in part by reducing 
regulatory burdens.

DATES: This order is effective June 5, 2026. The classification was 
applicable on March 29, 2023.

FOR FURTHER INFORMATION CONTACT: Ryan Trombetta, Center for Devices and 
Radiological Health, Food and Drug Administration, 10903 New Hampshire 
Ave., Bldg. 66, Rm. 4520, Silver Spring, MD 20993-0002, 301-837-7355, 
<a href="/cdn-cgi/l/email-protection#57052e3639790325383a353223233617313336793f3f2479303821"><span class="__cf_email__" data-cfemail="dc8ea5bdb2f288aeb3b1beb9a8a8bd9cbab8bdf2b4b4aff2bbb3aa">[email&#160;protected]</span></a>.

SUPPLEMENTARY INFORMATION:

I. Background

    Upon request, FDA (the Agency or we) has classified the absorbable 
metallic bone fixation fastener into class II (special controls), which 
we have determined will provide a reasonable assurance of safety and 
effectiveness of the device. In addition, we believe this action will 
enhance patients' access to beneficial innovation, in part by reducing 
regulatory burdens by placing the device into a lower device class than 
the automatic class III assignment.
    The automatic assignment of class III occurs by operation of law 
and without any action by FDA, regardless of the level of risk posed by 
the new device. Any device that was not in commercial distribution 
before May 28, 1976, is automatically classified into, and remains 
within, class III and requires premarket approval unless and until FDA 
takes an action to classify or reclassify the device (21 U.S.C. 
360c(f)(1)). We refer to these devices as ``postamendments devices'' 
because they were not in commercial distribution prior to the date of 
enactment of the Medical Device Amendments of 1976, which amended the 
Federal Food, Drug, and Cosmetic Act (FD&C Act).
    FDA may take a variety of actions in appropriate circumstances to 
classify or reclassify a device into class I or II. We may issue an 
order finding a new device to be substantially equivalent under section 
513(i) of the FD&C Act (21 U.S.C. 360c(i)) to a predicate device that 
does not require premarket approval. We determine whether a new device 
is substantially equivalent to a predicate device by means of the 
procedures for premarket notification under section 510(k) of the FD&C 
Act (21 U.S.C. 360(k)) and part 807 (21 CFR part 807).
    FDA may also classify a device through ``De Novo'' classification, 
a common name for the process authorized under section 513(f)(2) of the 
FD&C Act (see also part 860, subpart D (21 CFR part 860, subpart D)). 
Section 207 of the Food and Drug Administration Modernization Act of 
1997 (Pub. L. 105-115) established the first procedure for De Novo 
classification. Section 607 of the Food and Drug Administration Safety 
and Innovation Act (Pub. L. 112-144) modified the De Novo 
classification process by adding a second procedure. A device sponsor 
may utilize either procedure for De Novo classification.
    Under the first procedure, the person submits a premarket 
notification (510(k)) for a device that has not previously been 
classified. After receiving an order from FDA classifying the device 
into class III under section 513(f)(1) of the FD&C Act, the person then 
requests a classification under section 513(f)(2).
    Under the second procedure, rather than first submitting a 510(k) 
and then a request for classification, if the person determines that 
there is no legally marketed device upon which to base a determination 
of substantial equivalence, that person requests a classification under 
section 513(f)(2) of the FD&C Act.
    Under either procedure for De Novo classification, FDA is required 
to classify the device by written order within 120 days. The 
classification will be according to the criteria under section 
513(a)(1) of the FD&C Act. Although the device was automatically placed 
within class III, the De Novo classification is considered to be the 
initial classification of the device.

[[Page 34147]]

    We believe this De Novo classification will enhance patients' 
access to beneficial innovation, in part by reducing regulatory 
burdens. When FDA classifies a device into class I or II via the De 
Novo process, the device can serve as a predicate for future devices of 
that type, including for 510(k)s (see section 513(f)(2)(B)(i) of the 
FD&C Act). As a result, other device sponsors do not have to submit a 
De Novo request or premarket approval application to market a 
substantially equivalent device (see section 513(i) of the FD&C Act, 
defining ``substantial equivalence''). Instead, sponsors can use the 
less burdensome 510(k) process, when necessary, to market their device.

II. De Novo Classification

    On May 4, 2022, FDA received Bioretec Ltd.'s request for De Novo 
classification of the RemeOs Screw LAG Solid device. FDA reviewed the 
request in order to classify the device under the criteria for 
classification set forth in section 513(a)(1) of the FD&C Act.
    We classify devices into class II if general controls by themselves 
are insufficient to provide reasonable assurance of safety and 
effectiveness of the device, but there is sufficient information to 
establish special controls that, in combination with the general 
controls, provide reasonable assurance of the safety and effectiveness 
of the device for its intended use (see section 513(a)(1)(B) of the 
FD&C Act). After review of the information submitted in the request, we 
determined that the device can be classified into class II with the 
establishment of special controls. FDA has determined that these 
special controls, in addition to the general controls, will provide 
reasonable assurance of the safety and effectiveness of the device.
    Therefore, on March 29, 2023, FDA issued an order to the requester 
classifying the device into class II. In this final order, FDA is 
codifying the classification of the device by adding 21 CFR 
888.3041.\1\ We have named the generic type of device ``absorbable 
metallic bone fixation fastener,'' and it is identified as an implant, 
such as a bone screw, pin, or Kirschner wire, composed of one or more 
absorbable metal or metal alloys and intended to provide rigid bone 
fixation suitable for osteosynthesis. The device is designed to fully 
absorb after osteosynthesis is achieved.
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    \1\ FDA notes that the ACTION caption for this final order is 
styled as ``Final amendment; final order,'' rather than ``Final 
order.'' Beginning in December 2019, this editorial change was made 
to indicate that the document ``amends'' the Code of Federal 
Regulations. The change was made in accordance with the Office of 
Federal Register's (OFR) interpretations of the Federal Register Act 
(44 U.S.C. chapter 15), its implementing regulations (1 CFR 5.9 and 
parts 21 and 22), and the Document Drafting Handbook.
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    FDA has identified the risks to health associated with this type of 
device and the measures required to mitigate these risks in table 1.

Table 1--Risks to Health and Mitigation Measures for Absorbable Metallic
                         Bone Fixation Fasteners
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       Identified risks to health              Mitigation measures
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Loss of bone fixation resulting from:
    <bullet> Premature device            Clinical data; Non-clinical
     absorption and formation of          performance testing; Shelf
     absorption byproducts                life testing; and Labeling.
    <bullet> Device breakage
    <bullet> Galvanic corrosion
    <bullet> Device aging
Adverse tissue reaction resulting from:  Biocompatibility evaluation;
                                          and Labeling.
    <bullet> Device material
    <bullet> Device absorption and
     absorption by-products
Infection..............................  Sterilization validation; Shelf
                                          life testing; Pyrogenicity
                                          testing; and Labeling.
Difficulties with revision surgery due   Clinical data; and Labeling.
 to screw absorption.
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    FDA has determined that special controls, in combination with the 
general controls, address these risks to health and provide reasonable 
assurance of safety and effectiveness of the device. For a device to 
fall within this classification, and thus avoid automatic 
classification in class III, it would have to comply with the special 
controls named in this final order. The necessary special controls 
appear in the regulation codified by this final order.
    Under the FD&C Act, submission of a premarket notification under 
section 510(k) is required to reasonably assure the safety and 
effectiveness of class II devices unless FDA determines that the device 
type should be exempt under section 510(m) of the FD&C Act. At this 
time FDA has not made this determination for absorbable metallic bone 
fixation fasteners. This device is therefore subject to premarket 
notification requirements under section 510(k) of the FD&C Act.

III. Analysis of Environmental Impact

    The Agency has determined under 21 CFR 25.34(b) that this action is 
of a type that does not normally have a significant effect on the human 
environment. Therefore, neither an environmental assessment nor an 
environmental impact statement is required.

IV. Paperwork Reduction Act of 1995

    This final order establishes special controls that refer to 
previously approved collections of information found in other FDA 
regulations and guidance. These collections of information are subject 
to review by the Office of Management and Budget (OMB) under the 
Paperwork Reduction Act of 1995 (44 U.S.C. 3501-3521). The collections 
of information in part 860, subpart D, regarding De Novo classification 
have been approved under OMB control number 0910-0844; the collections 
of information in 21 CFR part 814, subparts A through E, regarding 
premarket approval have been approved under OMB control number 0910-
0231; the collections of information in part 807, subpart E, regarding 
premarket notification submissions have been approved under OMB control 
number 0910-0120; the collections of information in 21 CFR part 820 
regarding quality management system regulation have been approved under 
OMB control number 0910-0073; and the collections of information in 21 
CFR part 801 regarding labeling have been approved under OMB control 
number 0910-0485.

List of Subjects in 21 CFR Part 888

    Medical devices.


[[Page 34148]]


    Therefore, under the Federal Food, Drug, and Cosmetic Act and under 
authority delegated to the Commissioner of Food and Drugs, 21 CFR part 
888 is amended as follows:

PART 888--ORTHOPEDIC DEVICES

0
1. The authority citation for part 888 continues to read as follows:

    Authority:  21 U.S.C. 351, 360, 360c, 360e, 360j, 360l, 371.


0
2. Add Sec.  888.3041 to subpart D to read as follows:


Sec.  888.3041  Absorbable metallic bone fixation fastener.

    (a) Identification. An absorbable metallic bone fixation fastener 
is an implant, such as a bone screw, pin, or Kirschner wire, composed 
of one or more absorbable metal or metal alloys and intended to provide 
rigid bone fixation suitable for osteosynthesis. The device is designed 
to fully absorb after osteosynthesis is achieved.
    (b) Classification. Class II (special controls). The special 
controls for this device are:
    (1) Clinical data must demonstrate that the device performs as 
intended under the anticipated conditions of use. The absorption 
profile must be characterized to completion (full absorption). The 
difficulty of any revision surgeries must be documented.
    (2) Non-clinical performance testing must demonstrate that the 
product performs as intended under anticipated conditions of use. 
Testing must:
    (i) Evaluate the complete degradation profile of the device;
    (ii) Evaluate the initial mechanical performance; and
    (iii) Evaluate the mechanical performance as the device degrades.
    (3) The device must be demonstrated to be biocompatible.
    (4) The device must be demonstrated to be non-pyrogenic.
    (5) Performance data must demonstrate the sterility of the device.
    (6) Performance data must support the labeled shelf-life of the 
device by demonstrating continued sterility, package integrity, and 
device functionality (i.e., degradation profile and mechanical 
performance) over the established shelf life.
    (7) Labeling must include:
    (i) Material composition;
    (ii) Absorption byproducts;
    (iii) A detailed summary of the product's technical parameters;
    (iv) An expiration date/shelf life;
    (v) Instructions for revision surgery;
    (vi) Time to complete absorption; and
    (vii) A summary of clinical data with the device.

Grace R. Graham,
Deputy Commissioner for Policy, Legislation, and International Affairs.
[FR Doc. 2026-11302 Filed 6-4-26; 8:45 am]
BILLING CODE 4164-01-P


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Indexed from Federal Register on June 5, 2026.

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