K Number
K143352

Validate with FDA (Live)

Date Cleared
2014-12-24

(30 days)

Product Code
Regulation Number
862.1660
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The IMMULITE® Ferritin Calibration Material (CVM) is for in vitro diagnostic use in the verification of calibration of the IMMULITE Ferritin assay on the IMMULITE 2000 systems.

The IMMULITE® IGFBP-3 Calibration Material (CVM) is for in vitro diagnostic use in the verification of calibration of the IMMULITE IGFBP-3 assay on the IMMULITE 2000 systems

Device Description

The Ferritin Calibration Verification Material (CVM) contains one set of four vials. CVM1 contains 5.0mL of human serum albumin with preservatives. CVM2, CVM3, and CVM4 contain 2.0mL/vial of various levels of human ferritin in a human serum albumin matrix with preservatives. The CVMs are supplied in liquid form.

IMMULITE® 2000 IGFBP-3 Calibration Verification Material (CVM) contains one set of four vials each 2.0mL/vial. CVM1 contains bovine protein buffer matrix with preservatives. CVM2, CVM3 and CVM4 contain various levels of processed human serum (source of IGFBP-3) in bovine protein buffer matrix with preservatives. The CVMs are supplied in liquid form.

AI/ML Overview

The document describes the acceptance criteria and stability studies for two calibration verification materials: the IMMULITE® 2000 Ferritin Calibration Verification Material (CVM) and the IMMULITE® 2000 IGFBP-3 Calibration Verification Material (CVM).

Here's a breakdown of the requested information for each device:

IMMULITE® 2000 Ferritin Calibration Verification Material (CVM)

1. Table of acceptance criteria and reported device performance

Acceptance Criteria for Stability of IMMULITE 2000 Ferritin CVM (from Table 3):

CVM levelAssigned Dose (ng/mL)Guideline Criteria % difference to assigned doseAcceptable dose range (ng/mL)
LFECVM10.00Not Applicable≤ 1.5
LFECVM216.2± 14 %13.9 - 18.5
LFECVM3241± 8 %222 - 260
LFECVM41909± 15 %1623 - 2195

Reported Device Performance (Stability Summary - Section 7.1 and 7.1.1):
The document states that the IMMULITE® 2000 Ferritin Calibration Verification Materials are stable for up to 18 months when stored at 2-8°C prior to opening, and for 8 hours at ambient or room temperature (15-25°C) after reconstitution. The stability study involved testing CVM levels at time points 0, 6, 12, and 18 months, with "dose value determined from the reference calibrator curve." For open component testing, results were determined at 2-hourly intervals for up to 9 hours and compared to time zero. The document implies that the device met these criteria, as it concludes: "Performance testing has been carried out to demonstrate that this device meets the performance specifications for its intended use." and "The substantial equivalence of the device is supported by the non-clinical testing...". However, specific numerical results of the stability study demonstrating adherence to each range are not explicitly provided in the excerpt.

2. Sample size used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)

  • Test Set Sample Size: For stability testing, CVMs and reference CVMs were run in duplicate (as a minimum) at specified time points (0, 6, 12, 18 months). For open component testing, Ferritin CVM lot 016A was tested at 2-hourly intervals for up to 9 hours. For value assignment and expected values, each CVM level was tested on 4 different days, on 15 replicates in total, comprised of 5 runs, 3 replicates per run, 5 IMMULITE 2000 systems and 3 different reagent kit lots. Additionally, five levels of commercially available controls and 30 samples (15 spiked and 15 normal samples) were used to validate calibrator/CVM value assignments.

  • Data Provenance: Not explicitly stated. The manufacturer is Siemens Healthcare Diagnostics Inc. in Tarrytown, NY, USA, suggesting a US-based or international company, but specific country of origin for the data is not mentioned, nor is it specified if the data is retrospective or prospective. Given it's a stability study, it would be prospective data collection.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience)

  • Number of experts: Not applicable. This is a calibration verification material for an in vitro diagnostic assay, where "ground truth" (or assigned value) is established through a metrological traceability chain rather than expert consensus on medical images or clinical outcomes.
  • Qualifications of experts: Not applicable.

4. Adjudication method (e.g. 2+1, 3+1, none) for the test set

  • Adjudication method: Not applicable. The process involves direct measurement against reference calibrators and statistical analysis, not human adjudication of observations. The CVM values are calculated based on recovered values for each run on each instrument independently and then averaged across all systems.

5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

  • MRMC study: Not applicable. This device is a quality control material for an automated assay, not an AI-assisted diagnostic tool involving human readers.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done

  • Standalone study: The performance evaluated here is inherently "standalone" in the sense that it's the performance of the calibration material itself when run on the IMMULITE 2000 systems. There isn't an "algorithm only" device for this type of product separate from its use with the instrument.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc.)

  • Type of Ground Truth: The ground truth for the Ferritin CVMs is based on traceability to WHO 2nd IS 80/578 and internal value assignment using assigned reference calibrators. These reference calibrators are prepared using Ferritin antigen stock. This represents a form of metrological traceability to an international standard.

8. The sample size for the training set

  • Training Set Sample Size: Not explicitly applicable in the conventional sense of machine learning algorithms. The concept of a "training set" doesn't directly apply here. However, the value assignment process, which determines the "target values" for the CVMs, involves extensive testing with multiple replicates, instruments, and reagent lots. It's the equivalent of establishing the expected performance characteristics based on a large internal dataset.

9. How the ground truth for the training set was established

  • Ground Truth for Training Set: The "ground truth" (i.e., assigned values) for the calibrators and CVMs are established by Siemens Healthcare Diagnostics Inc. using a process outlined in Section 7.3 "Value Assignment". It involves:
    • Traceability to WHO 2nd IS 80/578.
    • Using assigned reference calibrators prepared with Ferritin antigen stock.
    • Testing CVMs on 4 different days, 15 replicates in total (5 runs, 3 replicates per run), 5 IMMULITE 2000 systems, and 3 different reagent kit lots.
    • Generating CVM dose values from curves generated by assigned reference calibrators, with values calculated for each run/instrument independently and then averaged across all systems.
    • Quality control through recovery of patient samples and commercial controls using the assigned CVM values, which must fall within their target ranges.

IMMULITE® 2000 IGFBP-3 Calibration Verification Material (CVM)

1. Table of acceptance criteria and reported device performance

Acceptance Criteria for Stability of IMMULITE 2000 IGFBP-3 CVM (from Table 3):

CVM levelAssigned Dose (µg/mL)Guideline Criteria % difference to assigned doseAcceptable dose range (µg/mL)
LGBCVM10.00N/A≤ 0.5
LGBCVM21.10± 10%0.99 - 1.21
LGBCVM34.12± 10%3.71 - 4.53
LGBCVM418.9± 15%16.1 - 21.7

Reported Device Performance (Stability Summary - Section 7.1 and 7.1.1):
The document states that the IMMULITE® 2000 IGFBP-3 Calibration Verification Materials are stable for up to 4 years when stored at -20°C. The stability study involved testing CVM levels at time points 0, 30, 36, and 48 months, with "dose value determined from the reference calibrator curve." Similar to the Ferritin CVM, the document implies that the device met these criteria, concluding: "Performance testing has been carried out to demonstrate that this device meets the performance specifications for its intended use." and "The substantial equivalence of the device is supported by the non-clinical testing...". Specific numerical results of the stability study demonstrating adherence to each range are not explicitly provided.

2. Sample size used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)

  • Test Set Sample Size: For stability testing, CVMs and reference CVMs were run in duplicate (as a minimum) at specified time points (0, 30, 36, 48 months). For value assignment and expected values, each CVM level was tested on 3 different days, on 15 replicates in total, comprised of 5 runs, 3 replicates per run, 3 IMMULITE 2000 systems and 3 different reagent kit lots. Additionally, two levels of commercially available controls and 30 diluted normal samples were used to validate calibrator/CVM value assignments.

  • Data Provenance: Not explicitly stated. The manufacturer is Siemens Healthcare Diagnostics Inc. in Tarrytown, NY, USA, suggesting a US-based or international company, but specific country of origin for the data is not mentioned, nor is it specified if the data is retrospective or prospective. Given it's a stability study, it would be prospective data collection.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience)

  • Number of experts: Not applicable. This is a calibration verification material for an in vitro diagnostic assay, where "ground truth" (or assigned value) is established through a metrological traceability chain.
  • Qualifications of experts: Not applicable.

4. Adjudication method (e.g. 2+1, 3+1, none) for the test set

  • Adjudication method: Not applicable. The process involves direct measurement against reference calibrators and statistical analysis, not human adjudication of observations. The CVM values are calculated based on recovered values for each run on each instrument independently and then averaged across all systems.

5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

  • MRMC study: Not applicable. This device is a quality control material for an automated assay, not an AI-assisted diagnostic tool involving human readers.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done

  • Standalone study: The performance evaluated here is inherently "standalone" in the sense that it's the performance of the calibration material itself when run on the IMMULITE 2000 systems. There isn't an "algorithm only" device for this type of product separate from its use with the instrument.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc.)

  • Type of Ground Truth: The ground truth for the IGFBP-3 CVMs is based on traceability to WHO NIBSC Reagent 93/560 and internal value assignment using assigned reference calibrators. These reference calibrators are prepared using IGFBP-3 antigen stock. This represents a form of metrological traceability to an international standard.

8. The sample size for the training set

  • Training Set Sample Size: Not explicitly applicable in the conventional sense of machine learning algorithms. However, the value assignment process, which determines the "target values" for the CVMs, involves extensive testing with multiple replicates, instruments, and reagent lots. It's the equivalent of establishing the expected performance characteristics based on a large internal dataset.

9. How the ground truth for the training set was established

  • Ground Truth for Training Set: The "ground truth" (i.e., assigned values) for the calibrators and CVMs are established by Siemens Healthcare Diagnostics Inc. using a process outlined in Section 7.3 "Value Assignment". It involves:
    • Traceability to WHO NIBSC Reagent 93/560.
    • Using assigned reference calibrators prepared with IGFBP-3 antigen stock.
    • Testing CVMs on 3 different days, 15 replicates in total (5 runs, 3 replicates per run), 3 IMMULITE 2000 systems, and 3 different reagent kit lots.
    • Generating CVM dose values from curves generated by assigned reference calibrators, with values calculated for each run/instrument independently and then averaged across all systems.
    • Quality control through recovery of patient samples, spiked patient samples, and commercial controls using the assigned CVM values, which must fall within their target ranges.

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Image /page/0/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features a stylized representation of a human figure, with three profiles overlapping to create a sense of depth and connection. The profiles are rendered in a dark color, contrasting with the white background. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular pattern around the figure.

Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609 Silver Spring, MD 20993-0002

January 23, 2015

Siemens Healthcare Diagnostics Inc. c/o Ms. Sara Kastrup Regulatory Clinical Affairs Specialist 511 Benedict Avenue Tarrytown, NY 10591

Re: K143352

Trade/Device Name: IMMULITE® 2000 Ferritin Calibration Verification Material (CVM) IMMULITE® 2000 IGFBP-3 Calibration Verification Material (CVM) Regulation Number: 21 &CFR 862.1660 Regulation Name: Quality Control Material (assayed and unassayed) Regulatory Class: Class I, Reserved Product Code: JJX Dated: November 21, 2014 Received: November 24, 2014

Dear Ms. Kastrup:

This letter corrects our substantially equivalent letter of December 24, 2014.

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 (see 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 equivalence 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

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Page 2 - Ms. Kastrup

comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); 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.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), 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/Resourcesfor You/Industry/default.htm. Also, please note the regulation entitled. "Misbranding by reference to premarket notification" (21CFR 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/ReportaProblem/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,

Elizabeth A. Stafford -S

for Maria M. Chan, Ph.D. Director Division of Immunology and Hematology Devices Office of In Vitro Diagnostics and Radiological Health Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known) K143352

Device Name

IMMULITE® 2000 Ferritin Calibration Verification Material (CVM) IMMULITE® 2000 IGFBP-3 Calibration Verification Material (CVM)

Indications for Use (Describe)

The IMMULITE® Ferritin Calibration Material (CVM) is for in vitro diagnostic use in the verification of calibration of the IMMULITE Ferritin assay on the IMMULITE 2000 systems

The IMMULITE® IGFBP-3 Calibration Material (CVM) is for in vitro diagnostic use in the verification of calibration of the IMMULITE IGFBP-3 assay on the IMMULITE 2000 systems

Type of Use (Select one or both, as applicable)

Prescription Use (Part 21 CFR 801 Subpart D)

| Over-The-Counter Use (21 CFR 801 Subpart C)

Form Approved: OMB No. 0910-0120

Expiration Date: January 31, 2017

See PRA Statement below.

CONTINUE ON A SEPARATE PAGE IF NEEDED.

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"An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number."

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510(k) Summary

510(k) Summary – IMMULITE 2000 Ferritin Calibration Master Verification Material

Introduction: According to the requirements of 21 CFR 807.92, the following information provides sufficient details to understand the basis for determination of substantial equivalence.

The assigned 510(k) Number: K143352

    1. Submitter: Mailing Address:
      Contact Person:

Phone Number: Fax Number: E-mail Address: Date Prepared:

    1. Device Name: Proprietary Name: Measurand: Type of Test:
      Regulation Section: Classification: Products Code: Panel:
    1. Predicate Device Name: Predicate 510(k) No:
  1. Device Description:

Siemens Healthcare Diagnostics Inc. 511 Benedict Avenue Tarrytown, NY 10591

Sara Kastrup Regulatory Clinical Affairs Specialist (914)-524-2317 (914)-524-2101 sara.kastrup@siemens.com December 23, 2014

IMMULITE® 2000 Ferritin Calibration Verification Material Quality Control materials for IMMULITE® 2000 Ferritin assay Calibration Verification Material (CVM) for IMMULITE® 2000 Ferritin assay 21 CFR 862.1660, Quality Control Material Class I Reserved JJX - Single (Specified) Analyte Controls (Assayed and Unassayed) Clinical Chemistry (75)

IMMULITE® 2000 HCG Calibration Verification Material (CVM) K133128

The Ferritin Calibration Verification Material (CVM) contains one set of four vials. CVM1 contains 5.0mL of human serum albumin with preservatives. CVM2, CVM3, and CVM4 contain 2.0mL/vial of various levels of human ferritin in a human serum albumin matrix with preservatives. The CVMs are supplied in liquid form.

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  1. Intended Use: Indication for Use: See Indications for Use Statement below: The IMMULITE® Ferritin Calibration Verification Material (CVM) is for in vitro diagnostic use in the verification of calibration of the IMMULITE Ferritin assay on the IMMULITE 2000 systems.

For prescription use only

IMMULITE® 2000 Systems

Special Conditions for Use Statement(s): Special Instrument Requirements:

    1. Technological Characteristics and Substantial Equivalence Comparison with Predicate:
      A comparison of the device features, intended use, and other information demonstrates that the IMMULITE® 2000 Ferritin Calibration Verification Material (CVM) is substantially equivalent to the predicate device as summarized in Table 1.

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Table 1: Substantial Equivalence Comparison

SIMILARITIES
Candidate DeviceIMMULITE 2000 Ferritin CVMPredicate DeviceIMMULITE 2000 HCG CVM
IntendedUseThe IMMULITE® Ferritin CalibrationVerification Material (CVM) is for invitro diagnostic use in the verificationof calibration of the IMMULITEFerritin assay on the IMMULITE 2000systems.The IMMULITE® HCG CalibrationVerification Material (CVM) is for invitro diagnostic use in the verificationof calibration of the IMMULITEHCG assay on the IMMULITE 2000systems.
FormLiquidSame
StabilityStable unopened until the expirationdateSame
Levels4Same
UseSingle Use OnlySame
DIFFERENCES
Candidate DeviceIMMULITE 2000 Ferritin CVMPredicate DeviceIMMULITE 2000 HCG CVM
AnalyteFerritinHCG
Storage2 -8 °C-20°C
MatrixHuman Serum Albumin withPreservativesHuman Serum with Preservatives

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7. Non-Clinical Performance Testing

Performance testing has been carried out to demonstrate that this device meets the performance specifications for its intended use. The following tests were performed on the candidate device.

7.1 Stability Summary:

The stability study was conducted to validate real-time shelf life and open component (in-use or open vial) claim for the IMMULITE 2000 Ferritin Calibration Verification Material (CVM) to ensure that it maintains optimal product performance on IMMULITE 2000 platforms throughout the established shelf life of the CVM before and after reconstitution.

The IMMULITE® 2000 Ferritin Calibration Verification Materials: The Calibration Verification Materials are stable up to 18 months when stored at 2-8℃ prior to opening and for 8 hours at ambient or room temperature (15-25°C) after reconstitution.

7.1.1 Stability Protocol Summary:

The CVM study protocols are run as part of the calibrator stability testing. The stability CVMs and reference CVMs are run in duplicate (as a minimum) at the time points shown in Table 2 and the dose value determined from the reference calibrator curve.

I album do Dialulity I link I Villas
CVM levelTime-Points (months)
LFECVM1C1218
LFECVM261218
LFECVM361218
LFECVM461218

Table 2: Stability Time Points

For Open Component testing, the results are determined from a 2-point adjustment. Using IMMULITE 2000 Ferritin (L2KFE2) kit lot 327, Ferritin CVM lot 016A was tested at 2hourly intervals for up to 9 hours at ambient or room temperature (15-25°C) conditions and compared to the determinations at time zero.

7.1.2 Stability Acceptance Criteria Summary:

The Acceptance Criteria for the IMMULITE Ferritin requires dose value of stability calibrator/CVM to fall between ±14% of assigned dose for CVM level 2. ±8% for CVM level 3 and 15% for CVM level 4. The sponsor's acceptance criteria are summarized in Table 3.

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CVM levelAssigned Dose(ng/mL)Guideline Criteria% difference toassigned doseAcceptabledose range(ng/mL)
LFECVM10.00Not Applicable1.5
LFECVM216.2$ ± 14 % $13.9-18.5
LFECVM3241$ ± 8 % $222-260
LFECVM41909$ ± 15 % $1623-2195

Table 3 Acceptance criteria for stability of IMMULITE 2000 Ferritin CVM

7.2 Traceability:

The IMMULITE Ferritin is traceable to WHO 2nd IS 80/578. The CVMs are manufactured using qualified materials and measurement procedures.

7.3 Value Assignment:

IMMULITE Ferritin CVMs are 4 level materials which are a subset of 10 level Ferritin calibrators. Calibrators are not commercialized but are used internally during manufacture and release testing of Ferritin reagents and two point adjustors.

The IMMULITE calibrators and therefore CVMs are value assigned using assigned reference calibrators. The assigned reference calibrators are prepared using Ferritin antigen stock and are traceable to WHO 2nd IS 80/578. Five levels of commercially available controls and 30 samples (15 spiked and 15 normal samples were used to validate calibrator/CVM value assignments.

The CVMs are manufactured using qualified materials and measurement procedures. The IMMULITE Ferritin calibrators/CVMs were tested on 4 different days, on 15 replicates in total, comprised of 5 runs, 3 replicates per run, 5 IMMULITE 2000 systems and 3 different reagent kit lots. The CVMs dose values are generated using curve generated by assigned reference calibrators. The CVM values are calculated based on the recovered values for each run on each instrument independently. CVM values are then averaged across all systems. Quality control is performed by calculating the recovery of patient samples and controls using the assigned CVM values. The controls must fall within their target ranges.

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7.4 Expected Values/Reference Range:

Each CVM level was tested on 4 different days, on 15 replicates in total, comprised of 5 runs, 3 replicates per run, 5 IMMULITE 2000 systems and 3 different reagent kit lots. The Guideline Range (95% confidence interval) for each CVM level was established based on the Target Mean and ± 2 Standard Deviation (SD). The expected values are provided in the IMMULITE® 2000 CVM Calibration Verification Material lot-specific package insert.

The expected assay range is up to 1500 ng/mL. The target values in Table 4 can be considered as guidelines; each lot will have lot-specific values.

Analyte target levelsCVM LevelTarget Mean (ng/mL)Standard Deviation (SD)Guideline ±2SD Range (ng/mL)
LFECVM10.00-0.00 - 1.50
LFECVM216.21.1513.9 - 18.5
LFECVM324613.5219 - 273
LFECVM42051--
75% LFECVM4+ 25% LFECVM11538115.51307 - 1769
Assay RangeUp to 1500 ng/mL

Table 4: Target Values

Each laboratory should establish their limits for acceptability based on methodology, clinical significance and medical decision levels of the test analyte. The representative, total precision tabulated in the respective assay instructions for use may be considered as one factor when establishing local, acceptable ranges. The values provided above may be considered as guidelines. Value assignment is lot-specific.

7.5 Standard/Guidance Documents Referenced:

  • CEN 13640 Stability Testing of In Vitro Diagnostic Reagents ●
  • Guidance for Industry Abbreviated 510(k) Submissions for In Vitro Diagnostic Calibrators ●
  • . Guidance for Industry and FDA Staff - Assayed and Unassayed Quality Control Material

7.6 Proposed Labeling:

The labeling is sufficient and it satisfies the requirements of 21 CFR Part 809.10

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8. Conclusion:

The IMMULITE® 2000 Ferritin Calibration Verification Material is substantially equivalent to other products in commercial distribution intended for similar use. Most notably, it is substantially equivalent to the FDA cleared IMMULITE® 2000 HCG Calibration Verification Material. The substantial equivalence of the device is supported by the non-clinical testing and was found to be comparable and supports the claims of substantial equivalence, product safety and effectiveness. Based on the testing completed and the comparisons with predicate device, the IMMULITE® 2000 Ferritin Calibration Verification Material does not raise any new questions on safety and effectiveness and the results support a determination of substantial equivalence.

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510(k) Summary - IMMULITE 2000 IGFBP-3 Calibration Master Verification Material

Introduction: According to the requirements of 21 CFR 807.92, the following information provides sufficient details to understand the basis for determination of substantial equivalence. The assigned 510(k) Number: K143352

1. Submitter:Mailing Address:Siemens Healthcare Diagnostics Inc.511 Benedict AvenueTarrytown, NY 10591
Contact Person:Phone Number:Fax Number:E-mail Address:Date Prepared:Sara KastrupRegulatory Clinical Affairs Specialist(914)-524-2317(914)-524-2101sara.kastrup@siemens.comDecember 23, 2014
2. Device Name:Proprietary Name:Measurand:Type of Test:Regulation Section:Classification:Products Code:IMMULITE® 2000 IGFBP-3 Calibration Verification MaterialQuality Control material for IMMULITE® 2000 IGFBP-3 assayCalibration Verification Material (CVM) for IMMULITE® 2000IGFBP-3 assay21 CFR 862.1660, Quality Control MaterialClass I ReservedJJX - Single (Specified) Analyte Controls (Assayed and Unassayed)
Panel:Clinical Chemistry (75)
3. Predicate Device NamePredicate 510(k) No:IMMULITE® 2000 IGF-1 Calibration Verification Material (CVM)K140818
4. Device Description:IMMULITE® 2000 IGFBP-3 Calibration Verification Material(CVM) contains one set of four vials each 2.0mL/vial .CVM1contains bovine protein buffer matrix with preservatives. CVM2,CVM3 and CVM4 contain various levels of processed human serum(source of IGFBP-3) in bovine protein buffer matrix withpreservatives. The CVMs are supplied in liquid form.
5. Intended Use:See Indications for Use Statement below
Indication for Use:The IMMULITE® IGFBP-3 Calibration Verification Material (CVM)is for in vitro diagnostic use in the verification of calibration of theIMMULITE IGFBP-3 assay on the IMMULITE 2000 systems.
Special Conditionsfor Use Statement(s):For prescription use only
Special InstrumentRequirements:IMMULITE® 2000 Systems
6. TechnologicalCharacteristics andSubstantial EquivalenceComparison with Predicate:A comparison of the device features, intended use, and otherinformation demonstrates that the IMMULITE® IGFBP-3 CalibrationVerification Material (CVM) is substantially equivalent to thepredicate device as summarized in Table 1.

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SIEN ।ENS

Table 1: Substantial Equivalence Comparison

SIMILARITIES
Candidate DeviceIMMULITE 2000IGFBP-3 CVMPredicate DeviceIMMULITE 2000 IGF-1 CVM
IntendedUseThe IMMULITE® IGFBP-3 CalibrationVerification Material (CVM) is for in vitrodiagnostic use in the verification ofcalibration of the IMMULITE IGFBP-3assay on the IMMULITE 2000 systemsThe IMMULITE® IGF-1Calibration Verification Material(CVM) is for in vitro diagnostic usein the verification of calibration ofthe IMMULITE IGF-1 assay on theIMMULITE 2000 systems
Storage-20°CSame
StabilityStable unopened until the expiration dateSame
Levels4Same
UseSingle Use OnlySame
MatrixBovine Protein with preservativesSame
FormLiquidSame
DIFFERENCES
Candidate DeviceIGFBP-3 CVMPredicate DeviceIMMULITE 2000 IGF-1 CVM
AnalyteIGFBP-3IGF-1

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7. Non-Clinical Performance Testing

Performance testing has been carried out to demonstrate that this device meets the performance specifications for its intended use. The following tests were performed on the candidate device.

7.1 Stability Summary:

The stability study was conducted to validate shelf life claim for the IMMULITE 2000 IGFBP-3 Calibration Verification Material (CVM) to ensure that it maintains optimal product performance on IMMULITE 2000 platforms throughout the established shelf life of the CVM before and after reconstitution.

The IGFBP-3 Calibration Verification Materials are stable up to 4 years when stored at -20℃.

7.1.1 Stability Protocol Summary:

The CVM study protocols are run as part of the calibrator stability testing. The stability CVMs and reference CVMs are run in duplicate (as a minimum) at the time points shown in Table 2 and the dose value determined from the reference calibrator curve.

CVM LevelTime-Points (months)
0303648
LGBCVM10303648
LGBCVM20303648
LGBCVM30303648
LGBCVM40303648

Table 2: Stability Time Points

7.1.2 Stability Acceptance Criteria Summary:

The sponsor's Acceptance Criteria for the IMMULITE IGFBP-3 criteria requires dose value of stability calibrator/CVM to fall between ±10% of assigned dose for CVM level 2 and level 3, and ±15% for CVM level 4.

The acceptance criteria are summarized in Table 3.

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able 3 Acceptance criteria for stability of IMMULITE 2000 IGFBP-3 CVM

CVM levelAssigned Dose(µg /mL)GuidelineCriteria% difference toassigned doseAcceptable doserange (µg /mL)
LGBCVM10.00N/A≤0.5
LGBCVM21.10±10%0.99-1.21
LGBCVM34.12±10%3.71-4.53
LGBCVM418.9±15%16.1-21.7

7.2 Traceability:

The IMMULITE IGFBP-3 CVMs are traceable to WHO NIBSC Reagent 93/560. The CVMs are manufactured using qualified materials and measurement procedures.

7.3 Value Assignment:

The IGFBP-3 CVMs are 4 level materials are a subset of 8 level IGFBP-3 calibrators. Calibrators are not commercialized but are used internally during manufacture and release testing of IGFBP-3 reagents and two point adjustors.

The IMMULITE calibrators and therefore CVMs are value assigned using assigned reference calibrators. The assigned reference calibrators are prepared using IGFBP-3 antigen stock and are traceable to WHO NIBSC Reagent 93/560. Two levels of commercially available controls and 30 diluted normal samples were used to validate calibrator/CVM value assignments.

The calibrators/CVMs are manufactured using qualified materials and measurement procedures. The calibrators/CVMs were tested on 3 different days, on 15 replicates in total, comprised of 5 runs, 3 replicates per run, 3 IMMULITE 2000 systems and 3 different reagent kit lots. The CVMs dose values are generated using curve generated by assigned reference calibrators. The CVM values are calculated based on the recovered values for each run on each instrument independently. CVM values are then averaged across all systems. Quality control is performed by calculating the recovery of patient samples, spiked patient samples and controls using the assigned CVM values. The controls must fall within their target ranges.

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7.4 Expected Values/Reference Range:

Each CVM level was on 3 different days, on 15 replicates in total, comprised of 5 runs, 3 replicates per run, 3 IMMULITE 2000 systems and 3 different reagent kit lots. The Guideline Range (95% confidence interval) for each CVM level was established based on the Target Mean and ± 2 Standard Deviation (SD). The expected values are provided in the IMMULITE® 2000 IGFBP-3 CVM Calibration Verification Material lot-specific package insert.

The expected assay range is up to16 ug/mL. The target values in Table 4 can be considered as guidelines; each lot will have lot-specific values.

Analytetarget levelsCVM LevelTargetMean(µg/mL)StandardDeviation(SD)Guideline ±2SD Range(µg/mL)
LGBCVM10.00-0.00 – 0.5
LGBCVM20.9150.05750.80 – 1.03
LGBCVM34.110.313.49 – 4.7
LGBCVM417.8--
90% LGBCVM4 +10% LGBCVM116.01.213.6 – 18.4
Assay RangeUp to 16 µg /mL
Table 4: Target Values
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Note: CVM4 requires dilution to ensure that the target value is within +10% of the reportable range of the assay

Each laboratory should establish their limits for acceptability based on methodology, clinical significance and medical decision levels of the test analyte. The representative, total precision tabulated in the respective assay instructions for use may be considered as one factor when establishing local, acceptable ranges. The values provided above may be considered as guidelines. Value assignment is lot-specific.

7.5 Standard/Guidance Documents Referenced:

  • · CEN 13640 Stability Testing of In Vitro Diagnostic Reagents
  • · Guidance for Industry Abbreviated 510(k) Submissions for In Vitro Diagnostic Calibrators
  • · Guidance for Industry and FDA Staff Assayed and Unassayed Quality Control Material

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7.6 Proposed Labeling:

The labeling is sufficient and it satisfies the requirements of 21 CFR Part 809.10

8. Conclusion:

The IMMULITE® 2000 IGFBP-3 Calibration Verification Material is substantially equivalent to other products in commercial distribution intended for similar use. Most notably, it is substantially equivalent to the FDA cleared IMMULITE® 2000 IGF-1 Calibration Verification Material. The substantial equivalence of the device is supported by the non-clinical testing and was found to be comparable and supports the claims of substantial equivalence, product safety and effectiveness. Based on the testing completed and the comparisons with predicate device, the IMMULITE® 2000 IGFBP-3 Calibration Verification Material does not raise any new questions on safety and effectiveness and the results support a determination of substantial equivalence.

§ 862.1660 Quality control material (assayed and unassayed).

(a)
Identification. A quality control material (assayed and unassayed) for clinical chemistry is a device intended for medical purposes for use in a test system to estimate test precision and to detect systematic analytical deviations that may arise from reagent or analytical instrument variation. A quality control material (assayed and unassayed) may be used for proficiency testing in interlaboratory surveys. This generic type of device includes controls (assayed and unassayed) for blood gases, electrolytes, enzymes, multianalytes (all kinds), single (specified) analytes, or urinalysis controls.(b)
Classification. Class I (general controls). Except when intended for use in donor screening tests, quality control materials (assayed and unassayed) are exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 862.9.