OptumSI Implant System

Basic Information

• Brand Name: OptumSI Implant System
• Primary DI: 00850057247190
• Version / Model: 11-11540
• Company Name: SI Solutions, LLC
• Labeler DUNS: 120155935
• Distribution Status: In Commercial Distribution
• Device Count in Pkg: 1
• Record Status: Published
• Publish Date: 2025-12-16
• Public Version: 1
• Public Version Date: 2025-12-24
• Public Version Status: New
• Public Device Record Key: 1808492d-b286-424a-94b1-96b5ac03b40c

Device Description

Sacroiliac Joint Fusion Implant, 11.5mm x 40mm

Device Characteristics

• Single Use: Yes
• Prescription Use (Rx): Yes
• Over the Counter (OTC): No
• Kit: No
• Combination Product: No
• HCT/P: No
• Contains NRL: No
• Not Made with NRL: No
• MRI Safety: MR Unsafe
• Direct Marking Exempt: No
• PM Exempt: No
• Has Serial Number: No
• Has Lot/Batch Number: Yes
• Has Manufacturing Date: No
• Has Expiration Date: Yes
• Has Donation ID: No

Sterilization

• Is Sterile: Yes
• Sterilization Prior Use: No

Product Codes

Code	Name	Medical Specialty	Regulation #	Device Class
OUR	Sacroiliac Joint Fixation	Orthopedic	888.3040	2

GMDN Terms

Code	Name	Definition	Implantable	Status
61485	Sacroiliac joint transarticular fixation/arthrodesis implant, uncoated	An implantable device designed to be inserted across the sacroiliac joint to provide temporary stabilization and to encourage long-term joint fusion, typically to alleviate pain from the joint. It is made of uncoated metal [e.g., titanium (Ti)], and typically in the form of a cylinder which may be threaded and/or fenestrated. It is typically surgically implanted under fluoroscopic guidance and may include dedicated disposable implantation instruments.	Yes	Active

Identifiers

Type	ID	Issuing Agency	Package Type	Qty per Pkg	Pkg Status	Pkg Discontinue Date
Primary	00850057247190	GS1

Premarket Submissions

Submission Number	Supplement Number
K251365	000

Device Sizes

Type	Value	Unit	Text
Length	40	Millimeter
Width	11.5	Millimeter