CR3 KEYLESS SPLIT SAMPLE CUP AMPHETAMINE-COCAINE
Device Facts
| Record ID | K141532 |
|---|---|
| Device Name | CR3 KEYLESS SPLIT SAMPLE CUP AMPHETAMINE-COCAINE |
| Applicant | Guangzhou Wondfo Biotech Co., Ltd. |
| Product Code | DKZ · Clinical Toxicology |
| Decision Date | Jul 14, 2014 |
| Decision | SESE |
| Submission Type | Traditional |
| Regulation | 21 CFR 862.3100 |
| Device Class | Class 2 |
Intended Use
CR3 Keyless Split Sample Cup Amphetamine-Cocaine is a rapid test for the qualitative detection of d-Amphetamine (major metabolite of Amphetamine) and Benzoylecgonine (major metabolite of Cocaine) in human urine at a cutoff concentration of 1000ng/mL and 300ng/mL, respectively. The test provides only preliminary test results. A more specific alternative chemical method must be used in order to obtain a confirmed analytical result. GC/MS is the preferred confirmatory method. Clinical consideration and professional judgment should be exercised with any drug of abuse test result, particularly when the preliminary result is positive. For in vitro diagnostic use only. It is intended for over-the-counter and for prescription use.
Device Story
CR3 Keyless Split Sample Cup is a lateral flow immunochromatographic assay for qualitative detection of d-Amphetamine and Benzoylecgonine in human urine. Device uses competitive binding principle; mouse monoclonal anti-drug antibody-dye conjugates, fixed drug-protein conjugates, and anti-mouse IgG polyclonal antibodies are coated on test membranes. Urine sample is absorbed via capillary action; if analyte concentration is below cutoff, antibody-dye conjugates bind to immobilized drug-protein conjugates in Test Region (T), producing a colored line (negative result). If analyte is above cutoff, analyte binds to antibody-dye conjugate, preventing binding to Test Region (no colored line, positive result). Control line (C) forms regardless of drug presence. Device is used by lay users (OTC) or clinicians (prescription) to obtain preliminary drug screening results. Results require professional judgment and confirmatory testing via GC/MS. Benefits include rapid, point-of-care screening for drug metabolites.
Clinical Evidence
Bench testing only. Performance evaluated via precision studies (25 days, two runs/day), analytical specificity (cross-reactivity with metabolites/related compounds), and interference testing (physiological/pathological substances). Method comparison study performed with 80 clinical samples against GC/MS. Lay-user study conducted with 260 participants (diverse backgrounds, ages 21->50) across three sites, demonstrating high accuracy and agreement with GC/MS. Flesch-Kincaid reading grade level for package inserts was <7.
Technological Characteristics
Lateral flow immunochromatographic assay. Components: mouse monoclonal anti-drug antibody-dye conjugate, fixed drug-protein conjugates, anti-mouse IgG polyclonal antibodies on test membranes. Form factor: split sample cup. Connectivity: none. Energy source: none (capillary action). Stability: 4-30°C for 18 months.
Indications for Use
Indicated for qualitative detection of d-Amphetamine and Benzoylecgonine in human urine for OTC and prescription use. Cutoff concentrations: 1000ng/mL for Amphetamine, 300ng/mL for Cocaine. Provides preliminary results only; requires GC/MS confirmation.
Regulatory Classification
Identification
An amphetamine test system is a device intended to measure amphetamine, a central nervous system stimulating drug, in plasma and urine. Measurements obtained by this device are used in the diagnosis and treatment of amphetamine use or overdose and in monitoring levels of amphetamine to ensure appropriate therapy.
Special Controls
*Classification.* Class II (special controls). An amphetamine test system is not exempt if it is intended for any use other than employment or insurance testing or is intended for Federal drug testing programs. The device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 862.9, provided the test system is intended for employment and insurance testing and includes a statement in the labeling that the device is intended solely for use in employment and insurance testing, and does not include devices intended for Federal drug testing programs (*e.g.,* programs run by the Substance Abuse and Mental Health Services Administration (SAMHSA), the Department of Transportation (DOT), and the U.S. military).
Predicate Devices
- Wondfo Multi-Drug Urine Test Cup (k130665)
- Wondfo Multi-Drug Urine Test Panel (k130665)
Related Devices
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- K161214 — Wondfo Amphetamine Urine Test AMP 500 (Cup, Dipcard), Wondfo Cocaine Urine Test COC 150(Cup, Dipcard), Wondfo Methamphetamine Urine Test MET 500 (Cup, Dipcard) · Guangzhou Wondfo Biotech Co., Ltd. · Jun 27, 2016
- K152269 — Healgen Amphetamine Test (Strip, Cassette, Cup, Dip Card), Healgen Cocaine Test (Strip, Cassette, Cup, Dip Card), Healgen Methamphetamine Test (Strip, Cassette, Cup, Dip Card) · Healgen Scientific,, LLC · Sep 9, 2015
- K153465 — AssureTech Amphetamine Tests (Strip, Dip Card, Quick Cup, Turn-Key Split Cup), AssureTech Cocaine Tests (Strip, Dip Card, Quick Cup, Turn-Key Split Cup), AssureTech Morphine Tests (Strip, Dip Card, Quick Cup, Turn-Key Split Cup) · Assure Tech. (Hangzhou) Co, Ltd. · Mar 31, 2016
- K151478 — Wondfo CR3 Keyless Split Sample Cup · Guangzhou Wondfo Biotech Co., Ltd. · Jul 1, 2015
Submission Summary (Full Text)
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# 510(k) SUMMARY
# JUL 1 4 2014
1. Date: July 11, 2014 Submitter: Guangzhou Wondfo Biotech Co., Ltd. 2. No.8 Lizhishan Road, Science City, Luogang District, Guangzhou, P.R. China 510663 3. Contact person: Joe Shia LSI International Inc. 504 East Diamond Ave., Suite F Gaithersburg, MD 20878
Telephone: 240-505-7880 Fax: 301-916-6213 Email:shiajl@yahoo.com
- 4. Device Name: CR2 Keyless Split Sample Cup Amphetamine-Cocaine
Classification:
| Product | |
|---------|----------------|
| Code | CFR # |
| DKZ | 21CFR 862.3100 |
| DIO | 21CFR 862.3250 |
- 5. Predicate Devices: k130665 Wondfo Multi-Drug Urine Test Cup Wondfo Multi-Drug Urine Test Panel
- 6. Intended Use
CR3 Keyless Split Sample Cup Amphetamine-Cocaine is a rapid test for the qualitative detection of d-Amphetamine (major metabolite of Amphetamine) and Benzoylecgonine (major metabolite of Cocaine) in human urine at a cutoff concentration of 1000ng/mL and 300ng/mL, respectively.
The test provides only preliminary test results. A more specific alternative chemical method must be used in order to obtain a confirmed analytical result. GC/MS is the preferred confirmatory method. Clinical consideration and professional judgment should be exercised with any drug of abuse test result, particularly when the preliminary result is positive.
For in vitro diagnostic use only. It is intended for over-the-counter and for prescription use.
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- 7. Device Description
Split Sample Cup Amphetamine-Cocaine Keyless test uses The CR3 immunochromatographic assays for amphetamine and cocaine. The test is a lateral flow, one step system for the qualitative detection of d-Amphetamine (major metabolite of Amphetamine) and Benzoylecgonine (major metabolite of Cocaine) in human urine.
| Item | Device | Predicate |
|--------------------------|-------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------|
| Indication(s)<br>for use | For the qualitative determination of<br>Amphetamine and Cocaine in<br>human urine | Same, but also<br>detects other drugs in<br>human urine |
| Methodology | Competitive binding, lateral flow<br>immunochromatographic assays<br>based on the principle of antigen<br>antibody immunochemistry. | Same |
| Results | Qualitative | Same |
| Specimen<br>Type | Human urine | Same |
| Cut Off Values | Amphetamine: 1000ng/ml<br>Cocaine: 300ng/ml | Same for<br>Amphetamine and<br>Cocaine |
| Configurations | Cup | Cup, Panel |
| Conditions for<br>Use | Over-the-Counter & Prescription<br>Use | Same |
- 8. Substantial Equivalence Information
# 9. Test Principle
The CR3 Keyless Split Sample Cup Amphetamine-Cocaine test is a rapid test for the qualitative detection of d-Amphetamine and benzoylecgonine in urine samples and contains lateral flow chromatographic immunoassays for amphetamine and cocaine. Each assay uses a mouse monoclonal anti-drug antibody-dye conjugate, fixed drug-protein conjugates, and anti-mouse IgG polyclonal antibodies coated on the test membranes. When the absorbent end of the test is immersed into a urine sample, the urine is absorbed into the device by capillary action and mixes with the antibody-dye conjugate, flowing across the pre-coated membrane. At analyte concentrations below the target cut-off, antibody-dye conjugates bind to the drug-protein conjugate immobilized in the Test Region (T) of the device. This produces a colored test line that indicates a negative result. When analyte concentration is above the cut-off, analyte molecules bind to the antibody-dye conjugate, preventing the antibody-dye conjugate from binding to the drug-protein conjugate immobilized in the Test Region (T) of the device. No colored band shows in the test region, indicating a potentially
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positive result. A band should form in the control region (C) of the device regardless of the presence of drug or metabolite in the sample.
# 10. Performance Characteristics
- 1. Analytical Performance
- a. Precision
Precision studies were carried out for samples with concentrations of -100% cut-off, -75% cut-off, -50% cut-off, -25% cut-off, at the cut-off, +25% cut-off, +50% cut-off , +75% cut-off and +100% cut-off. For each concentration, tests were performed two runs per day for 25 days. All sample aliquots were masked and randomized. The results obtained are summarized in the following tables:
| Result<br>AMP | -100%<br>cut-off | -75%<br>cut-off | -50%<br>cut-off | -25%<br>cut-off | +25%<br>cut-off | +50%<br>cut-off | +75%<br>cut-off | +100%<br>cut-off |
|---------------|------------------|-----------------|-----------------|-----------------|-----------------|-----------------|-----------------|------------------|
| W11710501CU5 | 50-/0+ | 50-/0+ | 50-/0+ | 50-/0+ | 42+/8- | 50+/0- | 50+/0- | 50+/0- |
| W11710502CU5 | 50-/0+ | 50-/0+ | 50-/0+ | 50-/0+ | 43+/7- | 50+/0- | 50+/0- | 50+/0- |
| W11710503CU5 | 50-/0+ | 50-/0+ | 50-/0+ | 50-/0+ | 43+/7- | 50+/0- | 50+/0- | 50+/0- |
## A. For Amphetamine (AMP) testing
B. For Cocaine (COC) testing
| Result | -100%<br>cut-off | -75%<br>cut-off | -50%<br>cut-off | -25%<br>cut-off | cut-off | +25%<br>cut-off | +50%<br>cut-off | +75%<br>cut-off | +100%<br>cut-off |
|--------------|------------------|-----------------|-----------------|-----------------|---------|-----------------|-----------------|-----------------|------------------|
| W11710501CU5 | 50-/0+ | 50-/0+ | 50-/0+ | 50-/0+ | 41+/9- | 50+/0- | 50+/0- | 50+/0- | 50+/0- |
| W11710502CU5 | 50-/0+ | 50-/0+ | 50-/0+ | 50-/0+ | 43+/7- | 50+/0- | 50+/0- | 50+/0- | 50+/0- |
| W11710503CU5 | 50-/0+ | 50-/0+ | 50-/0+ | 50-/0+ | 42+/8- | 50+/0- | 50+/0- | 50+/0- | 50+/0- |
- b. Linearity
Not applicable.
- c. Stability
The CR3 Keyless Split Sample Cup Amphetamine-Cocaine is stable at 4-30°C for 18 months as determined by conducting accelerated and real-time stability testing.
Control materials are not provided with the device. The labeling provides information on how to obtain control materials.
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- d. Cut-off
A total of 125 amphetamine samples and 125 cocaine samples equally distributed at concentrations of -50%, -25%, at the cut-off, +25%, +50% of their respective cut-offs were labeled by a person who prepared them and would not participate in the sample testing. These samples were tested using three different lots by three different operators. Results were all positive at +25% and +50% cut-off and all negative at -25% and -50% cut-off for both cocaine and amphetamine. The following cut-off values for the test devices have been verified.
| Test | Calibrator | Cut-off (ng/ml) |
|----------------------|-----------------|-----------------|
| Amphetamine<br>(AMP) | d-Amphetamine | 1000 |
| Cocaine(COC) | Benzoylecgonine | 300 |
- Interference e.
Potential interfering substances found in human urine of physiological or pathological conditions were added to drug-free urine and to urine containing target drugs (d-amphetamine or benzoylecgonine) at 25% below and 25% above the cut-off. These urine samples were tested using three batches of the CR3Keyless Split Sample Cup Amphetamine-Cocaine by three different operators. Compounds that showed no interference at a concentration of 100ug/mL are summarized below:
# d-Amphetamine
| 4-Acetamidophenol | (-) Y Ephedrine | Penicillin-G |
|----------------------|------------------------|---------------------|
| Acetophenetidin | Erythromycin | Pentazocaine |
| N-Acetylprocainamide | β-Estradiol | Pentobarbital |
| Acetylsalicylic acid | Estrone-3-sulfate | Perphenazine |
| Aminopyrine | Ethyl-p-aminobenzoate | Phencyclidine |
| Amitryptyline | Fenfluramine | Phenelzine |
| Amobarbital | Fenoprofen | Phendimetrazine |
| Amoxicillin | Furosemide | Phenobarbital |
| Ampicillin | Gentisic acid | Phetoin |
| Ascorbic acid | Hemoglobin | L-Phenylephrine |
| Apomorphine | Hydralazine | β-Phenylethlamine |
| Aspartame | Hydrochlorothiazide | Phenylpropanolamine |
| Atropine | Hydrocodone | Prednisolone |
| Benzilic acid | Hydrocortisone | Prednisone |
| Benzoic acid | O-Hydroxyhippuric acid | Procaine |
| Benzoylecgonine | 3-Hydroxytyramine | Promazine |
| Bilirubin | Ibuprofen | Promethazine |
| Brompheniramine | Imipramine | D,L-Propanolol |
| Caffeine | (-) Isoproterenol | Propiomazine |
| Cannabidiol | Isoxsuprine | D-Propoxyphene |
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Cannabinol Chloralhydrate Chloramphenicol Chlordiazepoxide Chlorothiazide (±) Chlorpheniramine Chlorpromazine Chlorquine Cholesterol Clomipramine Clonidine Cocaine hydrochloride Codeine Cortisone (-) Cotinine Creatinine Deoxycorticosterone Dextromethorphan Diazepam Diclofenac Diflunisal Digoxin Diphenhydramine Doxylamine Ecgonine hydrochloride Ecgonine methylester (IR,2S)-(-)-Ephedrine L-Ephedrine
# Benzoylecgonine
Acetominophen Acetophenetidin N-Acetylprocainamide Acetylsalicylic acid Aminopyrine Amitryptyline Amobarbital Amoxicillin Ampicillin L-Ascorbic acid DL-Amphetamine Sulfate Apomorphine Aspartame Atropine Benzilic acid
Ketamine Ketoprofen Labetalol Levorphanol Loperamide Maprotiline Meperidine Meprobamate Methadone Methylphenidate Morphine-3-Dglucuronide Nalidixic acid Naloxone Naltrexone Naproxen Niacinamide Nifedipine Norcodein Norethindrone D-Norpropoxyphene Noscapine D.L-Octopamine Oxalic acid Oxazepam Oxolinic acid
Oxycodone Oxymetazoline Papaverine
Estrone-3-sulfate Ethyl-p-aminobenzoate Fenoprofen Furosemide Gentisic acid Hemoglobin Hydralazine Hydrochlorothiazide Hydrocodone Hydrocortisone O-Hydroxyhippuric acid p-Hydroxymethamphetamine 3-Hydroxytyramine Ibuprofen Imipramine
Quinidine Quinine Ranitidine Salicylic acid Secobarbital Serotonin Sulfamethazine Sulindac Temazepam Tetracycline Tetrahydrocortisone Tetrahydrozoline A9-THC-COOH Thebaine Thiamine Thioridazine D.L-Thyroxine Tolbutamine Triamterene Trifluoperazine Trimethoprim Trimipramine Tryptamine D, L-Tyrosine Uric acid
Verapamil Zomepirac
Papaverine Penicillin-G Pentobarbital Perphenazine Phencyclidine Phenelzine Phenobarbital Phentermine L-Phenylephrine ß-Phenylethylamine Phenylpropanolamine Prednisolone Prednisone Procaine Promazine
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Benzoic acid Iproniazid Benzphetamine (±) - Isoproterenol Isoxsuprine Bilirubin (±) -Brompheniramine Ketamine Caffeine Ketoprofen Cannabidiol Labetalol Cannabinol Levorphanol Chloralhydrate Loperamide Chloramphenicol Maprotiline Chlordiazepoxide Meperidine Chlorothiazide Meprobamate (±) -Chlorpheniramine Methadone Chlorpromazine (土) Chlorquine (主 Cholesterol Clomipramine Clonidine Morphine Sulfate Codeine Nalidixic acid Cortisone Naloxone (-) Cotinine Naltrexone Creatinine Naproxen Deoxycorticosterone Niacinamide Dextromethorphan Nifedipine Diazepam Norcodein Diclofenac Norethindrone Diflunisal Digoxin Noscapine Diphenhydramine DL-Octopamine Doxylamine Oxalic acid Ecgonine methylester Oxazepam (-) - Y-Ephedrine Oxolinic acid Erythromycin Oxycodone B-Estradiol Oxymetazoline
Methoxyphenamine 4-Methvlene dioxyamphetamine nydrochloride -Methylene vmethamphetamine Morphine-3-B-D glucuronide D-Norpropoxyphene
Promethazine DL-Propranolol D-Propoxyphene D-Pseudoephedrine Quinidine Quinine Ranitidine Salicylic acid Secobarbital Serotonin Sulfamethazine Sulindac Temazepam Tetracycline Tetrahydrocortisone, 3-Acetate Tetrahydrocortisone glucuronide) Tetrahydrozoline Thebaine Thiamine Thioridazine DL-Tyrosine Tolbutamide Triamterene Trifluoperazine Trimethoprim Trimipramine Tryptamine DL-Tryptophan Tyramine Uric acid Verapamil Zomepirac
- f. Specificity
To test the specificity, drug metabolites and other components that are likely to be present in urine samples were tested. The target drug (d-Amphetamine or Benzoylecgonine), its drug metabolites and the related compounds were studied. These samples were tested using three batches of the CR3Kevless Split Sample Cup Amphetamine-Cocaine by three different operators. The drug metabolites and other components were tested at different concentrations. The obtained lowest detectable concentration was used to calculate the cross-reactivity. Results are shown in the following tables.
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| AMP (Amphetamine)<br>(d-Amphetamine,<br>Cut-off=1000 ng/mL) | Result | % Cross-Reactivity |
|-------------------------------------------------------------|-----------------------------|--------------------------------|
| d-Amphetamine | Positive at 1,000<br>ng/mL | 100% |
| l-Amphetamine | Positive at 50,000<br>ng/mL | 2% |
| d,l-Amphetamine | Positive at 3,000<br>ng/mL | 33% |
| (+/-) 3,4-methylenedioxyamphetamine<br>(MDA) | Positive at 5,000<br>ng/mL | 20% |
| Phentermine | Positive at 3,000<br>ng/mL | 33% |
| d-Methamphetamine | >100,000 ng/mL | <1% |
| l-Methamphetamine | >100,000 ng/mL | <1% |
| Ephedrine | >100,000 ng/mL | <1% |
| 3,4-Methylenedioxyethylamphetamine<br>(MDEA) | >100,000 ng/mL | <1% |
| COC(Cocaine)<br>(Benzoylecgonine,<br>Cut-off=300 ng/mL) | Result | % Cross-Reactivity |
|---------------------------------------------------------|-----------------------------|--------------------|
| Benzoylecgonine | Positive at 300 ng/mL | 100% |
| Cocaine HCl | Positive at 750 ng/mL | 40% |
| Cocaethylene | Positive at 12,500<br>ng/mL | 2.4% |
| Ecgonine | Positive at 32,000<br>ng/mL | <1% |
#### Effect of Urinary Density and pH g.
Twelve urine samples of normal, high, and low specific density ranges (1.000 to 1.035) were collected and spiked with either d-Amphetamine or benzoylecgonine at 25% below and 25% above the corresponding cut-off level. These samples were tested using three batches of the CR3Keyless Split Sample Cup Amphetamine-Cocaine by three different operators.
The pH of an aliquot negative urine pool was adjusted to pH ranges of 4.00 to 9.00 in 1 pH unit increments and spiked with d-Amphetamine or benzoylecgonine at 25% below and 25% above the corresponding cut-off levels. These samples were tested using three batches of the CR3Keyless Split Sample Cup Amphetamine-Cocaine by three different operators.
The device performance was found not affected by varying urine density and pH.
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# 2. Comparison Studies
The method comparison for the CR3 Keyless Split Sample Cup Amphetamine-Cocaine was performed in-house with three laboratory assistants. Operators ran 80 (40 negative and 40 positive) unaltered clinical samples. The samples were masked and randomized. The obtained test results are compared to GC/MS results. The results are presented in the table below:
| Amphetamine | | | | | | |
|--------------------|----------|----------|----------------------------------------------------|------------------------------------------------------------------------|----------------------------------------------------------------------------|--------------------------------------------------------|
| Group<br>Operators | | Negative | Low<br>Negative by<br>GC/MS<br>(less than<br>-50%) | Near Cutoff<br>Negative by<br>GC/MS<br>(Between<br>-50% and<br>cutoff) | Near Cutoff<br>Positive by<br>GC/MS<br>(Between<br>the cutoff<br>and +50%) | High<br>Positive by<br>GC/MS<br>(greater<br>than +50%) |
| Viewer A | Positive | 0 | 0 | 3 | 17 | 20 |
| | Negative | 10 | 18 | 9 | 3 | 0 |
| Viewer B | Positive | 0 | 0 | 4 | 15 | 20 |
| | Negative | 10 | 18 | 8 | 5 | 0 |
| Viewer C | Positive | 0 | 0 | 3 | 16 | 20 |
| | Negative | 10 | 18 | 9 | 4 | 0 |
Discordant table:
| Viewer | Sample number | GC/MS result | Viewer result |
|----------|---------------|--------------|---------------|
| Viewer A | AMPC1035 | 811 | positive |
| Viewer A | AMPC1062 | 945 | positive |
| Viewer A | AMPC1065 | 987 | positive |
| Viewer A | AMPC1061 | 1033 | negative |
| Viewer A | AMPC1063 | 1002 | negative |
| Viewer A | AMPC1064 | 1014 | negative |
| Viewer B | AMPC1032 | 781 | positive |
| Viewer B | AMPC1035 | 811 | positive |
| Viewer B | AMPC1062 | 945 | positive |
| Viewer B | AMPC1065 | 987 | positive |
| Viewer B | AMPC1061 | 1033 | negative |
| Viewer B | AMPC1063 | 1002 | negative |
| Viewer B | AMPC1064 | 1014 | negative |
| Viewer B | AMPC1092 | 1185 | negative |
| Viewer B | AMPC1094 | 1312 | negative |
| Viewer C | AMPC1033 | 702 | positive |
| Viewer C | AMPC1035 | 811 | positive |
| Viewer C | AMPC1065 | 987 | positive |
| Viewer C | AMPC1061 | 1033 | negative |
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| Viewer C | AMPC1063 | 1002 | negative |
|----------|----------|------|----------|
| Viewer C | AMPC1091 | 1212 | negative |
| Viewer C | AMPC1093 | 1296 | negative |
Cocaine
| Group<br>Operators | | Negative | Low Negative by<br>GC/MS<br>(less than<br>-50%) | Near Cutoff Negative by<br>GC/MS<br>(Between<br>-50% and<br>cutoff) | Near Cutoff Positive by<br>GC/MS<br>(Between<br>the cutoff<br>and +50%) | High Positive by<br>GC/MS<br>(greater<br>than +50%) |
|--------------------|----------|----------|-------------------------------------------------|---------------------------------------------------------------------|-------------------------------------------------------------------------|-----------------------------------------------------|
| Viewer A | Positive | 0 | 0 | 4 | 16 | 20 |
| | Negative | 10 | 15 | 11 | 4 | 0 |
| Viewer B | Positive | 0 | 0 | 4 | 17 | 20 |
| | Negative | 10 | 15 | 11 | 3 | 0 |
| Viewer C | Positive | 0 | 0 | 4 | 15 | 20 |
| | Negative | 10 | 15 | 11 | 5 | 0 |
# Discordant table:
| Viewer | Sample number | GC/MS result | viewer results |
|----------|---------------|--------------|----------------|
| Viewer A | COCC1031 | 231 | positive |
| Viewer A | COCC1033 | 229 | positive |
| Viewer A | COCC1034 | 232 | positive |
| Viewer A | COCC1062 | 293 | positive |
| Viewer A | COCC1061 | 302 | negative |
| Viewer A | COCC1064 | 314 | negative |
| Viewer A | COCC1065 | 306 | negative |
| Viewer A | COCC1091 | 351 | negative |
| Viewer B | COCC1031 | 231 | positive |
| Viewer B | COCC1032 | 219 | positive |
| Viewer B | COCC1035 | 221 | positive |
| Viewer B | COCC1062 | 293 | positive |
| Viewer B | COCC1061 | 302 | negative |
| Viewer B | COCC1063 | 325 | negative |
| Viewer B | COCC1065 | 306 | negative |
| Viewer C | COCC1032 | 219 | positive |
| Viewer C | COCC1033 | 229 | positive |
| Viewer C | COCC1034 | 232 | positive |
| Viewer C | COCC1062 | 293 | positive |
| Viewer C | COCC1061 | 302 | negative |
| Viewer C | COCC1063 | 325 | negative |
| Viewer C | COCC1064 | 314 | negative |
| Viewer C | COCC1065 | 306 | negative |
| Viewer C | COCC1095 | 378 | negative |
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Lay-user study
A lay user study was performed at three intended user sites with 260 lay persons, of which, 20 tested for drug-free samples, 120 for d-Amphetamine samples, 120 for benzoylecgonine samples. They had diverse educational and professional backgrounds and ranged in age from 21 to >50 years. Urine samples were prepared at the following concentrations; -100%, +1-75%, +/-50%, +/-25% of the cut-off by spiking drug(s) into drug free-pooled urine specimens. The concentrations of the samples were confirmed by GC/MS. Each sample was aliquoted into individual containers, blind-labeled and randomized. Each participant was provided with the package insert, I blind labeled sample and a device. The results are summarized below:
| Cup format | | Number<br>of<br>samples | OTC user | | %Agreement<br>With<br>GC/MS |
|-----------------|---------------|-------------------------|----------|----------|-----------------------------|
| Drug | Concentration | | Negative | Positive | |
| Drug -free | -100% | 20 | 20 | 0 | 100% |
| d-Amphetamine | -75% | 20 | 20 | 0 | 100% |
| | -50% | 20 | 20 | 0 | 100% |
| | -25% | 20 | 16 | 4 | 80% |
| | +25% | 20 | 3 | 17 | 85% |
| | +50% | 20 | 0 | 20 | 100% |
| | +75% | 20 | 0 | 20 | 100% |
| Benzoylecgonine | -75% | 20 | 20 | 0 | 100% |
| | -50% | 20 | 20 | 0 | 100% |
| | -25% | 20 | 17 | 3 | 85% |
| | +25% | 20 | 4 | 16 | 80% |
| | +50% | 20 | 0 | 20 | 100% |
| | +75% | 20 | 0 | 20 | 100% |
Data analysis shows that all lay persons have carried out the test correctly and the results show good accuracy compared to theGC/MS. Also, a Flesch-Kincaid reading analysis was performed on both drug's package inserts (AMP and COC) and the score revealed a reading grade level of less than 7.
- 3. Clinical Studies
Not applicable
# 11. Conclusion
Based on the test principle and performance characteristics of the device, it's concluded that CR3 Keyless Split Sample Cup Amphetamine-Cocaine is substantially equivalent to the predicate.
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Public Health Service
Food and Orig Administration 10903 New Hampshire Avenue Document Comrol Center - WO66-G609 Silver Spring, MD 20993-0002
July 14, 2014
GUANGZHOU WONDFO BIOTECH CO., LTD. C/O JOE SHIA LSI INTERNATIONAL INC 504 EAST DIAMOND AVE. SUITE F GAITHERSBURG MD 20878
Re: K141532
Trade/Device Name: CR3 Keyless Split Sample Cup Amphetamine-Cocaine Regulation Number: 21 CFR 862.3100 Regulation Name: Amphetamine test system Regulatory Class: II Product Code: DKZ, DIO Dated: June 6, 2014 Received: June 10, 2014
Dear Mr. Shia:
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. 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 (sec 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 cquivalence 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 Parts 801 and 809): medical device reporting (reporting of medical device-related adverse events) (21 CFR 803): good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable. the electronic product radiation control provisions (Sections 531-542 of the Act): 21 CFR 1000-1050.
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Page 2-Mr. Shia
If you desire specific advice for your device on our labeling regulations (21 CFR Parts 801 and 809). please contact the Division of Industry and Consumer Education at its toll-free number (800) 638 2041 or (301) 796-7100 or at its Internet address
http://www.fda.gov/MedicalDevices/ResourcesforYou/Industrv/default.htm. 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
http://www.fda.gov/MedicalDevices/Safety/ReportalProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.
You may obtain other general information on your responsibilities under the Act from the Division of Industry and Consumer Education at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address
http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm.
Sincerely yours.
# Courtney H. Lias -S
Courtney H. Lias, Ph.D. Director Division of Chemistry and Toxicology Devices Office of In Vitro Diagnostics and Radiological Health Center for Devices and Radiological Health
Enclosure
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DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration
# Indications for Use
Form Approved: OMB No. 0910-0120 Expiration Date: January 31, 2017 See PRA Statement befow.
510(k) Number (if known) k141532
Device Name
CR3 Keyless Split Sample Cup Amphetamine-Cocaine
#### Indications for Use (Describe)
CR3 Kevless Split Sample Cup Amphetamine-Cocaine is a rapid test for the qualitative detection of d-Amphetamine (major metabolite of Amphetamine) and Benzoylecgonine (major metabolite of Cocaine) in human urine at a cutoff concentration of 1000ng/mL and 300ng/mL, respectively.
The test provides only preliminary test results. A more specific alternical method must be used in order to obtain a confirmed analytical result. GCMS is the preferred confirmatory method. Clinical consideration and professional iudement should be exercised with any drug of abuse test result, particularly when the presult is positive.
For in vitro diagnostic use only. It is intended for over-the-counter and for prescription use.
Type of Use (Select one or both, as applicable)
Prescription Use (Part 21 CFR 801 Subpart D)
2 Over-The-Counter Use (21 CFR 801 Subpart C)
# PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON A SEPARATE PAGE IF NEEDED.
#### FOR FDA USE ONLY
Concurrence of Center for Devices and Radiological Health (CDRH) (Signature)
# Denise Johnson-lyles -S
This section applies only to requirements of the Paperwork Reduction Act of 1995.
### *DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW."
The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:
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FORM FDA 3881 (1/14)
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