K Number
K011738
Device Name
ACCU-CHEK ACTIVE SYSTEM
Date Cleared
2001-06-20

(15 days)

Product Code
Regulation Number
862.1345
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Accu-Chek Active system is designed to quantitatively measure the concentration of glucose in capillary whole blood. The device is indicated for professional use and over-the-counter sale.
Device Description
Instrument Operating Principle -- photometry Reagent Test Principle -- glucose dehydrogenase
More Information

Not Found

Not Found

No
The summary describes a photometric glucose meter using glucose dehydrogenase, with no mention of AI, ML, image processing, or data training/testing sets typically associated with AI/ML devices.

No
The device is designed to measure glucose concentration, which is a diagnostic function, not a therapeutic one. It provides information for managing a condition but doesn't directly treat it.

Yes
The "Intended Use / Indications for Use" states the device is "designed to quantitatively measure the concentration of glucose in capillary whole blood," which is a diagnostic measurement.

No

The device description explicitly mentions "Instrument Operating Principle -- photometry" and "Reagent Test Principle -- glucose dehydrogenase," indicating the use of hardware components (photometer) and chemical reagents, which are not characteristic of a software-only medical device.

Yes, the Accu-Chek Active system is an IVD (In Vitro Diagnostic) device.

Here's why:

  • Intended Use: The intended use explicitly states that it is designed to "quantitatively measure the concentration of glucose in capillary whole blood." This is a measurement performed in vitro (outside the body) on a biological sample (blood).
  • Device Description: The description mentions "Instrument Operating Principle -- photometry" and "Reagent Test Principle -- glucose dehydrogenase." These are common principles used in laboratory and point-of-care diagnostic tests that analyze biological samples.
  • Anatomical Site: The sample is "Capillary whole blood," which is a biological specimen collected from the body for analysis.

These characteristics clearly align with the definition of an In Vitro Diagnostic device, which is used to examine specimens taken from the human body to provide information for diagnostic, monitoring, or screening purposes.

N/A

Intended Use / Indications for Use

The Accu-Chek Active system is designed to quantitatively measure the concentration of glucose in capillary whole blood. The device is indicated for professional use and over-the-counter sale.

Product codes (comma separated list FDA assigned to the subject device)

NBW, LFR

Device Description

Instrument Operating Principle -- photometry
Reagent Test Principle -- glucose dehydrogenase

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Not Found

Indicated Patient Age Range

The Accu-Chek Simplicity and Accu-Chek Active systems are designed to quantitatively measure the concentration of glucose in capillary whole blood. The test device is indicated for professional use and over-the-counter sale. This device is not suitable for testing neonate samples.

Intended User / Care Setting

professional use and over-the-counter sale.

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

Performance testing on the modified Accu-Chek Active System demonstrated that the device meets the performance requirements for its intended use. A multi-center performance study was conducted to evaluate the accuracy and precision of the modified device. The clinical data demonstrates that the performance of the Accu-Chek Active correlates well with the laboratory plasma glucose reference test method. All predetermined acceptance criteria were satisfied. The data also demonstrates that the Accu-Chek Active is substantially equivalent to the predicate device.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

Accu-Chek Simplicity System.

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 862.1345 Glucose test system.

(a)
Identification. A glucose test system is a device intended to measure glucose quantitatively in blood and other body fluids. Glucose measurements are used in the diagnosis and treatment of carbohydrate metabolism disorders including diabetes mellitus, neonatal hypoglycemia, and idiopathic hypoglycemia, and of pancreatic islet cell carcinoma.(b)
Classification. Class II (special controls). The device, when it is solely intended for use as a drink to test glucose tolerance, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 862.9.

0

K011738

JUN 2 0 2001

510(k) Summary

| Introduction | According to the requirements of 21 CFR 807.92, the following information
provides sufficient detail to understand the basis for a determination of
substantial equivalence. |
|-------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| 1) Submitter
name, address,
contact | Roche Diagnostics Corporation
9115 Hague Rd.
Indianapolis, IN 46250
(317) 845-2000
Contact Person: Mike Flis
Date Prepared: June 4, 2001 |
| 2) Device name | Proprietary name: Accu-Chek Active System
Classification name: Glucose dehydrogenase, glucose test system
(21 C.F.R. § 862.1345)(75LFR) |
| 3) Predicate
device | We claim substantial equivalence to the current legally marketed Accu-Chek
Simplicity System. |
| 4) Device
Description | Instrument Operating Principle -- photometry
Reagent Test Principle -- glucose dehydrogenase |
| 5) Intended use | The Accu-Chek Active system is designed to quantitatively measure the
concentration of glucose in capillary whole blood. The device is indicated for
professional use and over-the-counter sale. |

Continued on next page

1

The Roche Diagnostics Accu-Chek Active System is substantially equivalent 6) Similarities The Roone Diagnobile marketed Accu-Chek Simplicity System. The proposed to the current regarly manetees it in scope. The following is a list of some of the claims and features unaffected by the proposed modification.

Feature/ClaimDetail
Intended useThe Accu-Chek Simplicity and Accu-Chek Active systems are designed to
quantitatively measure the concentration of glucose in capillary whole blood.
The test device is indicated for professional use and over-the-counter sale. This
device is not suitable for testing neonate samples.
Test principleGlucose dehydrogenase chemical reaction. The instrument measures the extent
of color change (photometric) caused by the presence of glucose in the sample.
The amount of color change is related to the glucose concentration in the blood
sample.
Venous blood samplesAlthough the method comparison studies provide evidence that the device works
acceptably with venous blood samples, the labeling is limited to use with
capillary whole blood.
Monitor coding
procedureCode chip is provided with each carton of test strips.
Test strip storage
conditionsStore at room temperature between +36° F(+2° C) and +86° F(+30° C).
Test strip operating
conditionsBetween +5° F(+10° C) and +104° F(+40° C).
Quality control testing
frequencyTests should be run with liquid quality control materials whenever a new vial of
test strips is opened or an unusual blood test result is obtained.
Quality control
acceptable rangeThe mean is strip lot specific and will be determined individually. The range of
the controls is within ± 15 mg/dL or ± 15% compared to the determined mean.
Labeling instructions
regarding expected
resultsThe normal fasting adult blood glucose range for a non-diabetic is 70-105
mg/dL. One to two hours after meals, normal blood glucose levels should be
less than 140 mg/dL. Doctors will determine the range that is appropriate for the
patients.
Labeling instructions
regarding response to
unusual resultsRun a quality control test, if the result is outside the acceptable QC recovery
range contact Roche Diagnostics's Accu-Chek Customer Care center; if result is
within the acceptable range, review proper testing procedure and repeat blood
glucose test with a new test strip.
Acceptable sample
typesCapillary whole blood samples
Reportable range10-600 mg/dL
Hematocrit range30 - 55%
Warnings and
precautionsFor in vitro diagnostic use only.

Continued on next page

2

510(k) Summary, Continued

  1. Data demonstrating substantial equivalence

Performance testing on the modified Accu-Chek Active System demonstrated that the device meets the performance requirements for its intended use. A multi-center performance study was conducted to evaluate the accuracy and precision of the modified device. The clinical data demonstrates that the performance of the Accu-Chek Active correlates well with the laboratory plasma glucose reference test method. All predetermined acceptance criteria were satisfied. The data also demonstrates that the Accu-Chek Active is substantially equivalent to the predicate device.

3

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized eagle with three tail feathers, representing the department's mission to protect the health of all Americans and provide essential human services. The eagle is encircled by the words "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" in a circular arrangement.

Public Health Service

JUN 2 0 2001

Food and Drug Administration 2098 Gaither Road Rockville MD 20850

Mr. Mike Flis Regulatory Affairs Principal Roche Diagnostics corporation 9115 Hague Road Indianapolis, IN 46250

Re: 510(K) Number: K011738 Trade/Device Name: Accu-Chek Active Test System Regulation Number: 862.1345 Regulatory Class: II Product Code: NBW, LFR Dated: June 4, 2001 Received: June 5, 2001

Dear Mr. Flis:

We have reviewed your Section 510(k) notification of intent to market the device referenced above and we 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). 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.

If your device is classified (see above) into either class II (Special Controls) or class III (Premarket Approval), it may be subject to such additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 895. A substantially equivalent determination assumes compliance with the Current Good Manufacturing Practice requirements, as set forth in the Quality System Regulation (QS) for Medical Devices: General regulation (21 CFR Part 820) and that, through periodic QS inspections, the Food and Drug Administration (FDA) will verify such assumptions. Failure to comply with the GMP regulation may result in regulatory action. In addition, FDA may publish further announcements concerning your device in the Federal Register. Please note: this response to your premarket notification submission does not affect any obligation you might have under sections 531 through 542 of the Act for devices under the Electronic Product Radiation Control provisions, or other Federal laws or regulations.

4

Page 2

This letter will allow you to begin marketing your device as described in your 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predication. The results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801 and additionally 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4588. Additionally, for questions on the promotion and advertising of your device, (Jease contact the Office of Compliance at (301) 594-4639. Also, please note the regulation entitled "Misbranding by reference to premarket notification" (21CFR 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its internet address "http://www.fda.gov/cdrh/dsma/dsmamain.html".

Sincerely yours,

Steven Sutman

Steven I. Gutman, M.D., M.B.A. Director Division of Clinical Laboratory Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

5

Indications for Use Statement

510(k) Number (if known): Kou1738 Device Name: Accu-Chek Active Test System

Indications for Use:

The Accu-Chek Active system is designed to quantitatively measure the concentration of glucose in capillary whole blood. The device is indicated for professional use and over-the-counter sale.

(PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Fred Lacy

(Division Sign-Off Division of Clinica Laboratory Devices K011738 510(k) Number.

Prescription Use (Per 21 CFR 801.109) OR

Over-The-Counter Use

(Optional Format 1-2-96)