K Number
K012359
Device Name
TINA-QUANT COMPLEMENT C4 TEST SYSTEM
Date Cleared
2001-11-29

(127 days)

Product Code
Regulation Number
866.5240
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
In vitro diagnostic reagent system intended for use on COBAS INTEGRA systems for the quantitative immunological determination of human complement C4 in serum and plasma. Aid in detecting the presence and level of C4 found in autoimmune diseases, infections and inflammatory disorders.
Device Description
The Tina-quant Complement C4 Test System is based on the activation of the complement system which takes place via a classical and alternative route. Complement factor C4 participates in activation by the classical route. Human C4 forms a precipitate with a specific antiserum which is determined turbidimetrically.
More Information

Not Found

No
The description focuses on a turbidimetric assay for quantitative determination of C4, which is a standard laboratory technique and does not mention or imply the use of AI or ML.

No
The device is described as an "in vitro diagnostic reagent system" for the quantitative immunological determination of human complement C4, aiding in the detection of C4 levels related to certain conditions. It is not intended for treatment or prevention of diseases, but rather for diagnostic purposes.

Yes
The "Intended Use / Indications for Use" states that it is an "in vitro diagnostic reagent system" and that it is an "Aid in detecting the presence and level of C4 found in autoimmune diseases, infections and inflammatory disorders." This clearly indicates its role in diagnosis.

No

The device description clearly states it is an "In vitro diagnostic reagent system" and describes a turbidimetric method involving a precipitate and antiserum, indicating it is a physical reagent and not solely software.

Yes, this device is an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The "Intended Use / Indications for Use" section explicitly states it is an "In vitro diagnostic reagent system".
  • Purpose: It is designed for the "quantitative immunological determination of human complement C4 in serum and plasma," which are biological samples tested in vitro (outside the body).
  • Clinical Application: It is intended to "Aid in detecting the presence and level of C4 found in autoimmune diseases, infections and inflammatory disorders," indicating a diagnostic purpose.
  • Device Description: The description details a laboratory test method ("turbidimetrically") using reagents ("specific antiserum") to analyze a biological sample.

All these points align with the definition of an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

In vitro diagnostic reagent system intended for use on COBAS INTEGRA systems for the quantitative immunological determination of human complement C4 in serum and plasma. Aid in detecting the presence and level of C4 found in autoimmune diseases, infections and inflammatory disorders.

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

DBI

Device Description

The Tina-quant Complement C4 Test System is based on the activation of the complement system which takes place via a classical and alternative route. Complement factor C4 participates in activation by the classical route. Human C4 forms a precipitate with a specific antiserum which is determined turbidimetrically.

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

Not Found

Intended User / Care Setting

Not Found

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)

Not Found

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

Analytical Sensitivity: 0.04 g/L (4 mg/dL)
Measuring Range: 0.04-1.35 g/L (4-135 mg/dL)

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.

K951595

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

§ 866.5240 Complement components immunological test system.

(a)
Identification. A complement components immunological test system is a device that consists of the reagents used to measure by immunochemical techniques complement components C1q , C1r , C1s , C2 , C3 , C4 , C5 , C6 , C7 , C8 , and C9 , in serum, other body fluids, and tissues. Complement is a group of serum proteins which destroy infectious agents. Measurements of these proteins aids in the diagnosis of immunologic disorders, especially those associated with deficiencies of complement components.(b)
Classification. Class II (performance standards).

0

NOV 2 9 2001 510(k) Summary According to the requirements established in the Food and Drug Introduction Administration's guidance document entitled "The New 510(k) Paradigm: Alternate Approaches to Demonstrating Substantial Equivalence in Premarket Notifications", the following information provides sufficient detail to understand the basis for a determination of substantial equivalence. Roche Diagnostics Corporation 1) Submitter name, address, 9115 Hague Rd. Indianapolis, IN 46250 contact (317) 521-7643 Contact Person: Helen T. Torney Date Prepared: July 23, 2001 Tina-quant Complement C4 Test System Proprietary name: 2) Device name Complement C4 Test Common name: Classification name: Complement components immunological test system. We claim substantial equivalence to the currently marketed Tina-quant 3) Predicate Complement C4 Test System on Roche COBAS Integra Analyzers device (K951595)

1

510(k) Summary, Continued

| 4) Device
Description | The Tina-quant Complement C4 Test System is based on the activation of the
complement system which takes place via a classical and alternative route.
Complement factor C4 participates in activation by the classical route.
Human C4 forms a precipitate with a specific antiserum which is determined
turbidimetrically. |
|--------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| 5) Intended use | In vitro diagnostic reagent system intended for use on COBAS INTEGRA
systems for the quantitative immunological determination of human
complement C4 in serum and plasma. |
| 6.) Substantial
equivalence | The table below indicates the similarities between the modified Tina-quant
Complement C4 ver.2 Test System on COBAS Integra analyzers and the
predicate, Tina-quant Complement C4 Test System Roche (K951595). In
summary, the Tina-quant Complement C4 ver.2 Test System described in this
submission is, in our opinion, substantially equivalent to the predicate device. |

submission is, in our opinion, substantially equivalent to

| Topic | Modified
Tina-quant Complement C4 ver. | Tina-quant Complement C4
(cleared K951595) |
|------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------|
| Intended Use | In vitro diagnostic reagent system
intended for use on COBAS
INTEGRA systems for the
quantitative immunological
determination of human
complement C4 in serum and
plasma | For the in vitro quantitative
immunological determination of
human complement C4 in serum and
plasma. |
| Indication for Use | Aid in detecting the presence and
level of C4 found in autoimmune
diseases, infections and
inflammatory disorders. | Aid in detecting the presence and
level of C4 found in autoimmune
diseases, infections and
inflammatory disorders. |
| Analyzer | COBAS Integra analyzers | COBAS Integra analyzers |
| Sample Type | Human serum and plasma | Human serum |
| Analytical Sensitivity | 0.04 g/L (4 mg/dL) | 0.012 g/L (1.2mg/dL) |
| Wavelength | 340/659 nm | 340/659 nm |
| Measuring Range | 0.04-1.35 g/L
(4-135 mg/dL) | 0.06-0.9 g/L
(6-90 mg/dL) |

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DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/2/Picture/1 description: The image is a black and white logo for the U.S. Department of Health & Human Services. The logo features a stylized eagle with three lines forming its body and wings. The eagle is enclosed in a circle with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter.

Food and Drug Administration 2098 Gaither Road Rockville MD 20850

NOV 2 9 2001

Ms. Helen Torney Centralized Diagnostics Regulatory Submissions Roche Diagnostics Corporation 9115 Hague Road P.O. Box 50457 Indianapolis, IN 46250-0457

Re: K012359

Trade/Device Name: Tina-Quant Complement C4 ver.2 Test System Regulation Number: 21 CFR 866.5240 Regulation Name: Complement components immunological test system Regulatory Class: Class II Product Code: DBI Dated: October 12, 2001 Received: October 15, 2001

Dear Ms.Torney:

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.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), 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 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 comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); 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 -

This letter will allow you to begin marketing your device as described in your 510(k) premarket I his letter will anon-you of substantial equivalence of your device to a legally marketed predicate device 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 1 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, (301) 594-4560. I readers 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 mornlactor on Jour responsible and Consumer 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

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Indications for Use

510(k) Number (if known): V(012359 Device Name: Tina-quant Complement C4 ver.2 Test System

Indications for Use:

In vitro diagnostic reagent system intended for use on COBAS INTEGRA systems for the In viti o diagnostic reague of buman complement C4 in serum and plasma. qualificative inimulations and level of C4 found in autoimmune diseases, infections and inflammatory disorders.

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Seisen Altare

sion of Clinical Laboratory Devices

510(k) Number_Kol 2359

Prescription Use V (Per 21 CFR 801.109) OR

Over-The-Counter Use

(Optional Format 1-2-96)