510(k) Report

510(k) · Cleared

Recalled · Class II · 2021

Zimmer Natural Nail System Cephalomedullary Nails

K091566510(k) TraditionalCleared Oct 28, 2009153-day reviewClass II21 CFR 888.3020Recalls 5

Data to Oct 25, 2026 (FDA decisions) Oct 12, 2026 (recalls) Sep 30, 2026 (MAUDE) refreshed weekly, last Nov 3, 2026

Zimmer GmbH · HSB Rod, Fixation, Intramedullary And Accessories

Cleared on Oct 28, 2009 as substantially equivalent to K083497 (Zimmer, Inc., 2009) and 2 other predicates after a 153-day review. Its family tree reaches back 5 generations to 1997. 16 later devices descend from it. It has been recalled 5 times.

Decided
Oct 28, 2009
Review
153 days
Class
Class II
Product code
HSB
Recalls
5
Predicates
3

Its longest line of descent runs back 5 generations to K970097 (1997). 18 ancestors in all, the oldest K871539 (1987). 16 later devices descend from it, 6 citing it directly.

Other ancestors, by year clearedDescendants, by year cleared 2003: 1 other ancestor1997: 1 other ancestor2005: 1 other ancestor1996: 2 other ancestors2004: 1 other ancestor2002: 2 other ancestors2001: 2 other ancestors1998: 2 other ancestors1987: 1 other ancestor2018: 1 descendant cleared2024: 2 descendants cleared2019: 1 descendant cleared2012: 1 descendant cleared2023: 3 descendants cleared2014: 1 descendant cleared2022: 3 descendants cleared2025: 3 descendants cleared2026: 1 descendant clearedK970097 · Proximal Femoral Nail (PFN) System · Synthes (Usa) · 1997K973240 · Synthes Proximal Femoral Nail (PFN) System Modification · Synthes (Usa) · 1997K013563 · Long Trochanteric Nail System · DePuy Orthopaedics, Inc. · 2001 · recalledK033329 · Depuy Ace Universal and Troch Entry Femoral Nail Systems · Depuy, Inc. · 2003K083497 · Zimmer Natural Nail System Piriformis Fossa and Greater Trochanter Antegrade Femoral Nails · Zimmer, Inc. · 2009 · recalled1990200020102020
Other ancestors, by generationDescendants, by generation 1 generation back: 2 other ancestors2 generations back: 2 other ancestors3 generations back: 8 other ancestors4 generations back: 1 other ancestor 1 generation forward: 6 descendants2 generations forward: 6 descendants3 generations forward: 4 descendants K083497 · Zimmer Natural Nail System Piriformis Fossa and Greater Trochanter Antegrade Femoral Nails · Zimmer, Inc. · 2009 · recalledK033329 · Depuy Ace Universal and Troch Entry Femoral Nail Systems · Depuy, Inc. · 2003K013563 · Long Trochanteric Nail System · DePuy Orthopaedics, Inc. · 2001 · recalledK973240 · Synthes Proximal Femoral Nail (PFN) System Modification · Synthes (Usa) · 1997K970097 · Proximal Femoral Nail (PFN) System · Synthes (Usa) · 1997−50
  1. Root · 5 generations backK970097 Proximal Femoral Nail (PFN) SystemSynthes (Usa) · 1997
  2. 4 generations backK973240 Synthes Proximal Femoral Nail (PFN) System ModificationSynthes (Usa) · 1997
  3. 3 generations backK013563 Long Trochanteric Nail SystemDePuy Orthopaedics, Inc. · 2001 · Recalled
  4. 2 generations backK033329 Depuy Ace Universal and Troch Entry Femoral Nail SystemsDepuy, Inc. · 2003
  5. 1 generation backK083497 Zimmer Natural Nail System Piriformis Fossa and Greater Trochanter…Zimmer, Inc. · 2009 · Recalled
  6. This deviceK091566 Zimmer Natural Nail System Cephalomedullary NailsZimmer GmbH · 2009
  7. Descendant · cites it directly · 10 of its ownK120715 Zimmer Natural Nail System Cephalomedullary Femoral Nail - Asia ShortZimmer GmbH · 2012
  8. Descendant · cites it directly · 4 of its ownK231114 Zimmer® Natural Nail® System Cephalomedullary Nails; Affixus®…Zimmer Switzerland Manufacturing GmbH · 2023
  9. Descendant · cites it directly · 4 of its ownK192312 Zimmer Natural Nail System Cephalomedullary NailsZimmer GmbH · 2019
  10. Descendant · 2 generations on · 3 of its ownK213328 Gamma4 System, Gamma3 System, IMN Screws System, T2 Tibial Nailing…Stryker GmbH · 2022 · Recalled
  11. Descendant · cites it directly · 2 of its ownK241651 Affixus Tibial and Antegrade Femoral Nailing SystemZimmer, Inc. · 2024 · Recalled

Showing 5 of 16 descendants. See all descendants

Descendants cleared per year

2012: 12014: 12018: 12019: 12022: 32023: 32024: 22025: 32026: 1
2012high 3 (2022) · low 0 (2013)2026

Most influential descendants

Showing 5 of 16 · See all
  • K120715Zimmer Natural Nail System Cephalomedullary Femoral Nail - Asia ShortZimmer GmbH · 2012 · cites it directly10descendants
  • K231114Zimmer® Natural Nail® System Cephalomedullary Nails; Affixus® Natural Nail® Humeral Nail…Zimmer Switzerland Manufacturing GmbH · 2023 · cites it directly4descendants
  • K192312Zimmer Natural Nail System Cephalomedullary NailsZimmer GmbH · 2019 · cites it directly4descendants
  • K213328Gamma4 System, Gamma3 System, IMN Screws System, T2 Tibial Nailing SystemStryker GmbH · 2022 · 2 generations on3descendants
  • K241651Affixus Tibial and Antegrade Femoral Nailing SystemZimmer, Inc. · 2024 · cites it directly2descendants
View FIG. 1 as a table

Line of descent and top descendants

GenerationNumberDeviceApplicantDecidedRecalls
−5K970097Proximal Femoral Nail (PFN) SystemSynthes (Usa)1997—
−4K973240Synthes Proximal Femoral Nail (PFN) System ModificationSynthes (Usa)1997—
−3K013563Long Trochanteric Nail SystemDePuy Orthopaedics, Inc.200154
−2K033329Depuy Ace Universal and Troch Entry Femoral Nail SystemsDepuy, Inc.2003—
−1K083497Zimmer Natural Nail System Piriformis Fossa and Greater Trochanter Antegrade…Zimmer, Inc.200916
0 (this device)K091566Zimmer Natural Nail System Cephalomedullary NailsZimmer GmbH2009—
+1K120715Zimmer Natural Nail System Cephalomedullary Femoral Nail - Asia ShortZimmer GmbH2012—
+1K231114Zimmer® Natural Nail® System Cephalomedullary Nails; Affixus® Natural Nail®…Zimmer Switzerland Manufacturing GmbH2023—
+1K192312Zimmer Natural Nail System Cephalomedullary NailsZimmer GmbH2019—
+2K213328Gamma4 System, Gamma3 System, IMN Screws System, T2 Tibial Nailing SystemStryker GmbH20221
+1K241651Affixus Tibial and Antegrade Femoral Nailing SystemZimmer, Inc.202417

Other ancestors by year cleared

Year clearedDevicesWith a Class I recall
198710
199620
199710
199820
200120
200220
200310
200410
200510

Descendants by year cleared

Year clearedDevicesWith a Class I recall
201210
201410
201810
201910
202230
202330
202420
202530
202610
FIG. 1 — Lineage of K091566, 1997–2026Source: FDA 510(k) summaries, read by 510(k) Report · How lineage is built

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Notable FDA decisions, review times and new Class I recalls. See an issue.

Sources: FDA 510(k) database (decision fields), the FDA summary (predicates and indications), FDA recall and enforcement reports, and MAUDE; processed by 510(k) Report. Verify on FDA.gov · Methodology and accuracy.

Planning a device in HSB? A 510(k) Report weighs predicate choices, recall history and review times for a new device like this one.

Top candidate predicates for a new HSB device

  1. #1 K200869 Gamma3 Systemscore 19.8 · 8 generations · no Class I recall
  2. #2 Held for the reportin the report
  3. #3 Held for the reportin the report
Get a 510(k) Report

What was it cleared against? (3)

Devices the submitter claimed this one is substantially equivalent to (*), and reference devices cited for a specific test or feature (†), as written in the FDA summary.

TypeNumberDeviceApplicantDecidedRecalls
*K083497Zimmer Natural Nail System Piriformis Fossa and Greater Trochanter Antegrade Femoral Nails
Summary page 1
…stem Piriformis Fossa & Greater Trochanter Antegrade Femoral Nails, manufactured by Zimmer, Inc. (K083497, cleared February 19, 2009) I. T S. T TM Intertrochanter…
Zimmer, Inc.200916
*K032367Itst Intertrochanteric Subtrochanteric Intramedullary Femoral Nail
Summary page 1
…T TM Intertrochanteric Subtrochanteric Intramedullary Femoral Nail, manufactured by Zimmer, Inc. (K032367, cleared August 12, 2003) Intramedullary Nail System, manufactured by…
Zimmer, Inc.200312
*K965098Intramedullary Nail System
Summary page 1
…nc. (K032367, cleared August 12, 2003) Intramedullary Nail System, manufactured by Zimmer, Inc. (K965098, cleared February 28, 1997) Device Description: The Zimmer NaturalNail System…
Zimmer, Inc.199729

Also cleared against K083497: 6 other devices →

What descends from it? (16)

See all 16

6 later devices cite it directly; ranked here by how many devices descend from each in turn.

NumberDeviceApplicantDecidedDescendants
K120715Zimmer Natural Nail System Cephalomedullary Femoral Nail - Asia ShortZimmer GmbH201210
K231114Zimmer® Natural Nail® System Cephalomedullary Nails; Affixus® Natural Nail® Humeral Nail…Zimmer Switzerland Manufacturing GmbH20234
K192312Zimmer Natural Nail System Cephalomedullary NailsZimmer GmbH20194
K241651Affixus Tibial and Antegrade Femoral Nailing SystemZimmer, Inc.20242
K140601Flow-NailFlow-Fx, LLC20142
K181640X-BOLT Hip Fracture Fixation SystemX-Bolt Orthopaedics20181

Has anything in its family been recalled? (0 Class I)

Recalls of this device

DateClassRecallRoot causeReason
May 7, 2021Class IIZ-1792-2021Process designZimmer Natural Nail (ZNN) System-CMN Femoral Nail potential commingle between CCD angle 130 degree and 125 degree
May 7, 2021Class IIZ-1793-2021Process designZimmer Natural Nail (ZNN) System-CMN Femoral Nail potential commingle between CCD angle 130 degree and 125 degree
Oct 10, 2019Class IIZ-0337-2020Packaging change controlNon-highly polished implants may adhere to the LDPE bag (previous packaging configuration).
Sep 3, 2015Class IIZ-0119-2016Package design/selectionIn about 5% of tested samples, the outer tray was found to be compromised. Risks: A damaged outer tray detected during surgery may cause a delay in surgery to obtain another implant. If a compromised packaging is not detected prior or…
Oct 29, 2010Not classifiedZ-0824-2011Nonconforming Material/ComponentThe firm has determined that two lots of this instrument were inappropriately manufactured by the supplier. The manufacturing process created a step in the lumen which impedes the Lag Screw Retaining Shaft from passing through the lumen…

No ancestor or descendant has a Class I recall.

What does this lineage say?

  • The line of descent spans 12 years and passes through 5 companies; a new generation was cleared every 1.9 years on median.
  • 11 of the 18 ancestors have a recall of any class.
  • Of its descendants, K120715 (Zimmer GmbH, 2012) has gone furthest, with 10 descendants of its own.
  • 6 other devices also cite its predicate K083497.

How does its category compare?

All HSB devices

HSB Rod, Fixation, Intramedullary And Accessories: FDA decisions, review times, recalls and adverse event reports over 20 years. 2009, this device’s year, is highlighted.

FDA decisions per year · HSB

15in 2025

2007: 82008: 112009: 182010: 142011: 162012: 172013: 182014: 192015: 222016: 82017: 232018: 172019: 132020: 172021: 102022: 122023: 112024: 132025: 152026 (partial year): 18
2007high 23 (2017) · low 8 (2007)2026

2026 to Oct 25, outlined.

Median 510(k) review, days · HSB

106in 2025

2007: 68 days median2008: 57 days median2009: 86 days median2010: 117 days median2011: 78 days median2012: 112 days median2013: 105 days median2014: 147 days median2015: 111 days median2016: 124 days median2017: 119 days median2018: 134 days median2019: 132 days median2020: 112 days median2021: 94 days median2022: 172 days median2023: 162 days median2024: 195 days median2025: 106 days median2026 (partial year): 151 days median
2007high 195 (2024) · low 57 (2008)2026

Receipt to decision; years with fewer than 3 clearances left blank.

Recalls per year · HSB

18in 2025

2008: 92009: 812010: 182011: 22012: 72013: 142014: 32015: 32016: 62017: 662018: 562019: 62020: 62021: 22022: 12023: 12024: 12025: 182026 (partial year): 1
2007high 81 (2009) · low 0 (2007)2026

Class I (0 since 2007) Class II/III not classified

Adverse event reports per year · HSB

2,911in 2025

2007: 1622008: 1842009: 3342010: 4542011: 6622012: 1,0792013: 1,7732014: 1,4742015: 1,6712016: 1,9202017: 1,4472018: 3,5262019: 2,5172020: 3,2992021: 4,1112022: 2,7332023: 2,2192024: 2,8692025: 2,911
2007high 4,111 (2021) · low 162 (2007)2025

MAUDE reports naming product code HSB, not matched to any one device; reports are not rates.

View these four charts as a table
YearDecisionsMedian 510(k) review, daysRecalls (Class I)MAUDE reports
20078680162
200811579184
2009188681334
20101411718454
201116782662
20121711271,079
201318105141,773
20141914731,474
20152211131,671
2016812461,920
201723119661,447
201817134563,526
20191313262,517
20201711263,299
2021109424,111
20221217212,733
20231116212,219
20241319512,869
202515106182,911
2026181511—

What is it indicated for?

The Zimmer NaturalNail System is intended for temporary fracture fixation and stabilization of the bone.

Indications for use of the Cephalomedullary nails include:

· Compound and simple shaft fractures

· Proximal, metaphyseal and distal shaft fractures

· Segmental fractures

· Comminuted fractures

· Fractures involving osteopenic and osteoporotic bone

· Pathological fractures

* Fractures with bone loss

· Pseudoarthrosis, non-union, mal-union and delayed union

· Periprosthetic fractures

• Surgically created defects such as osteotomies

· Intertrochanteric and subtrochanteric fractures

Indications for use as stated in the FDA summary.

Cite this page

510(k) Report. “K091566: Zimmer Natural Nail System Cephalomedullary Nails.” Lineage record from FDA 510(k) data and the FDA summary. Updated Nov 3, 2026. Accessed Nov 5, 2026. https://510kreport.com/device/K091566

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Record history
  • FDA decision record loaded May 2, 2026
  • Summary read Oct 13, 2026 (extraction version 9eaa42aa01ed)
  • Lineage and recalls computed Nov 3, 2026
  • Page last updated Nov 3, 2026