K Number
K020487
Device Name
CARESIDE ALT
Manufacturer
Date Cleared
2002-06-04

(111 days)

Product Code
Regulation Number
862.1030
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
For in vitro diagnostic use with the CARESIDE Analyzer to quantitatively measure ALT from anti-coagulated whole blood, plasma, or serum specimens to aid in the diagnosis and treatment of patients with certain types of liver and heart disease.
Device Description
CARESIDE ALT cartridges are used with the CARESIDE, Inc. CARESIDE Analyzer to measure ALT activity in anti-coagulated whole blood, plasma, or serum specimens. The CARESIDE® ALT cartridge, a single use disposable in vitro diagnostic test cartridge, delivers a measured volume of sample to a dry film to initiate the measurement of ALT activity. The patented film cartridge contains all reagents necessary to measure ALT activity. Each CARESIDE ALT cartridge consists of an ALT-specific multi-layer reagent film mounted in a plastic base with a hinged lid. The user introduces the specimen into the cartridge sample well, closes the lid and inserts the cartridge into the CARESIDE Analyzer. Once loaded, the CARESIDE Analyzer scans the cartridge barcode, brings the cartridge and the contained specimen to 37℃, and spins the cartridge to move the sample from the sample well into the cartridge channels and chambers. Approximately 8.5 microliters of sample remains in the metering passage. Any excess sample flows into an overflow well. The sample is automatically dispensed onto the multi-layer reagent film. The spreading and substrate layer uniformly distributes the specimen. As the specimen passes through the spreading and substrate layer, ALT in the specimen catalyzes the reaction of L-aspartate and a-ketotglutaric acid to form pyruvic acid and L-glutamic acid (see Test Reaction Sequence). The pyruvic acid is converted to acetyl phosphoric acid, CO2 and hydrogen peroxide in the reaction layer. Peroxidase in the reaction layer then catalyzes the oxidation of a diaryliminidazole leuco dye by hydrogen peroxide to form a green dye. The rate of change of intensity of the color as measured by the amount of reflected light at 655 directly relates to the amount of ALT activity in the specimen.
More Information

Not Found

No
The description details a chemical reaction and optical measurement process, with no mention of AI or ML for data analysis or interpretation.

No.

Explanation: The device is an in vitro diagnostic test for measuring ALT levels, used to aid in diagnosis and treatment, which is a diagnostic function, not a therapeutic one.

Yes

The "Intended Use / Indications for Use" section explicitly states "For in vitro diagnostic use with the CARESIDE Analyzer to quantitatively measure ALT... to aid in the diagnosis and treatment of patients with certain types of liver and heart disease." This directly indicates its role as a diagnostic device.

No

The device description clearly outlines a physical cartridge and an analyzer, both of which are hardware components essential for the device's function. The software is likely part of the analyzer, but the device as a whole is not software-only.

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

Here's why:

  • Intended Use/Indications for Use: Explicitly states "For in vitro diagnostic use".
  • Device Description: Describes a "single use disposable in vitro diagnostic test cartridge".
  • Function: The device measures a substance (ALT) in a biological specimen (whole blood, plasma, or serum) to aid in diagnosis and treatment. This is the core function of an in vitro diagnostic device.
  • Performance Studies: The performance studies compare the device to a predicate device which is also an IVD (Vitros ALT DT Slides).

The document clearly and repeatedly identifies the device as being for in vitro diagnostic use.

N/A

Intended Use / Indications for Use

Intended Use: The CARESIDE® ALT cartridge is intended for in vitro diagnostic use in conjunction with the CARESIDE® Analyzer to quantitatively measure ALT activity in anti-coagulated whole blood, plasma, or serum.

Indications for Use: For in vitro diagnostic use with the CARESIDE Analyzer to quantitatively measure ALT from anti-coagulated whole blood, plasma, or serum specimens to aid in the diagnosis and treatment of patients with certain types of liver and heart disease.

Product codes

CKA

Device Description

CARESIDE ALT cartridges are used with the CARESIDE, Inc. CARESIDE Analyzer to measure ALT activity in anti-coagulated whole blood, plasma, or serum specimens. The CARESIDE® ALT cartridge, a single use disposable in vitro diagnostic test cartridge, delivers a measured volume of sample to a dry film to initiate the measurement of ALT activity. The patented film cartridge contains all reagents necessary to measure ALT activity.

Each CARESIDE ALT cartridge consists of an ALT-specific multi-layer reagent film mounted in a plastic base with a hinged lid. The user introduces the specimen into the cartridge sample well, closes the lid and inserts the cartridge into the CARESIDE Analyzer.

Once loaded, the CARESIDE Analyzer scans the cartridge barcode, brings the cartridge and the contained specimen to 37℃, and spins the cartridge to move the sample from the sample well into the cartridge channels and chambers. Approximately 8.5 microliters of sample remains in the metering passage. Any excess sample flows into an overflow well.

The sample is automatically dispensed onto the multi-layer reagent film. The spreading and substrate layer uniformly distributes the specimen. As the specimen passes through the spreading and substrate layer, ALT in the specimen catalyzes the reaction of L-aspartate and a-ketotglutaric acid to form pyruvic acid and L-glutamic acid (see Test Reaction Sequence). The pyruvic acid is converted to acetyl phosphoric acid, CO2 and hydrogen peroxide in the reaction layer. Peroxidase in the reaction layer then catalyzes the oxidation of a diaryliminidazole leuco dye by hydrogen peroxide to form a green dye. The rate of change of intensity of the color as measured by the amount of reflected light at 655 directly relates to the amount of ALT activity in the specimen.

As the cartridges spin, a photodiode measures reflectance of light emitted by a wavelength-specific light emitting diode (LED) over a fixed time period. The analyzer uses the reflectance measurements and the lot-specific standard curve to calculate ALT activity.

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: Nonclinical and clinical studies were performed.
Key Results: The nonclinical and clinical data provided demonstrate that the CARESIDE ALT product is as safe, effective, and performs as well as or better than the legally marketed predicate device.
Key Metrics:

  • Detection limit: CARESIDE ALT: 15 U/L; Vitros ALT DT Slides: 3 U/L
  • Reportable Range: CARESIDE ALT: 15 - 1000 U/L; Vitros ALT DT Slides: 3 - 950 U/L
  • Accuracy: CARESIDE ALT: Mean recovery 106%; Vitros ALT DT Slides: Not available
  • Precision: CARESIDE ALT: Total CV, 22 U/L, 4.5%; Vitros ALT DT Slides: Total CV, 40 U/L, 9.5%
  • Method Comparison: CARESIDE® = 0.98 (BM/Hitachi 902) + 4.75 U/L, r = 1.00
  • Linearity: Linearity by mixing yielded slope and correlation coefficient within acceptable limits
  • Interference: No significant interference observed at tested concentration of interferent: Ascorbic Acid, 10 mg/dL; Bilirubin, 20 mg/dL; Triglycerides 3000 mg/dL; Gamma globulin 4200 mg/dL. Predicate device showed high gamma globulin interference.

Key Metrics

See "Summary of Performance Studies" for key metrics.

Predicate Device(s)

K912844/A

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 862.1030 Alanine amino transferase (ALT/SGPT) test system.

(a)
Identification. An alanine amino transferase (ALT/SGPT) test system is a device intended to measure the activity of the enzyme alanine amino transferase (ALT) (also known as a serum glutamic pyruvic transaminase or SGPT) in serum and plasma. Alanine amino transferase measurements are used in the diagnosis and treatment of certain liver diseases (e.g., viral hepatitis and cirrhosis) and heart diseases.(b)
Classification. Class I (general controls). The device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to § 862.9.

0

(020487)

CARESIDE ALT Premarket Notificatio April 30, 2002

510(K) SUMMARY: CARESIDE® ALT SAFETY AND IV. EFFECTIVENESS

I. Applicant Information

  • Applicant Name A.
  • Applicant/Manufacturer B. Address
  • Telephone Number C.
  • Contact Person D.
  • FAX Number E.
  • e-Mail Address F.
  • G. Date 510(k) Summary prepared

II. Device Information

  • A. Device Name (Trade)
  • Device Name B. (Classification)

C. Device Classification

CARESIDE, Inc. 6100 Bristol Parkway Culver City, CA 90230 310-338-6767 Renate A. MacLaren, Ph.D. 310-670-6986 rmaclaren@CARESIDE.com April 30, 2002

CARESIDE® ALT ALT test system

Clinical chemistry panel ALT test system Regulation Number: 21 CFR 862.1030 Regulatory Class I Classification Number: to be assigned None applicable

  • Special controls and D. performance standards

III. Substantial Equivalence Claim

  • General equivalency claim A.
    The ability to monitor analyte-specific biochemical reactions in dry film and other formats is widely recognized and has gained widespread acceptance for use in chemistry assays. ALT in vitro diagnostic products, in both dry film and other formats, are already on the U.S. market.

B. Specific equivalency claim

The CARESIDE ALT test is substantially equivalent in principle, intended use, and clinical performance to the currently marketed Vitros slides for the quantitative measurement of ALT on the Vitros DT 60 II.

Name of Predicate Device: Johnson and Johnson's (formerly Eastman Kodak, Inc.) Vitros ALT DT Slides for Johnson and Johnson's Vitros DT 60 (formerly Eastman Kodak's DT 60 II).

1

Predicate Device 510K number:K912844/A
Product Code:75CKA

IV. Device Description

CARESIDE ALT cartridges are used with the CARESIDE, Inc. CARESIDE Analyzer to measure ALT activity in anti-coagulated whole blood, plasma, or serum specimens. The CARESIDE® ALT cartridge, a single use disposable in vitro diagnostic test cartridge, delivers a measured volume of sample to a dry film to initiate the measurement of ALT activity. The patented film cartridge contains all reagents necessary to measure ALT activity.

A. Explanation of Device Function

Each CARESIDE ALT cartridge consists of an ALT-specific multi-layer reagent film mounted in a plastic base with a hinged lid. The user introduces the specimen into the cartridge sample well, closes the lid and inserts the cartridge into the CARESIDE Analyzer.

Once loaded, the CARESIDE Analyzer scans the cartridge barcode, brings the cartridge and the contained specimen to 37℃, and spins the cartridge to move the sample from the sample well into the cartridge channels and chambers. Approximately 8.5 microliters of sample remains in the metering passage. Any excess sample flows into an overflow well.

The sample is automatically dispensed onto the multi-layer reagent film. The spreading and substrate layer uniformly distributes the specimen. As the specimen passes through the spreading and substrate layer, ALT in the specimen catalyzes the reaction of L-aspartate and a-ketotglutaric acid to form pyruvic acid and L-glutamic acid (see Test Reaction Sequence). The pyruvic acid is converted to acetyl phosphoric acid, CO2 and hydrogen peroxide in the reaction layer. Peroxidase in the reaction layer then catalyzes the oxidation of a diaryliminidazole leuco dye by hydrogen peroxide to form a green dye. The rate of change of intensity of the color as measured by the amount of reflected light at 655 directly relates to the amount of ALT activity in the specimen.

Test Reaction Sequence:

L-alanine + a-ketoglutaric acid - 415-

Pyruvic acid + L-glutamic acid

Pyruvic acid + O2 + phosphoric acid ->

H2O2 + CO2 + acetyl phosphoric acid

Diarylimidazole leuco dye + H2O2 - - Green dye + H2O

As the cartridges spin, a photodiode measures reflectance of light emitted by a wavelength-specific light emitting diode (LED) over a fixed time

2

period. The analyzer uses the reflectance measurements and the lotspecific standard curve to calculate ALT activity.

  • B. Test Summary
    Alanine aminotransferase, formerly known as serum glutamate pyruvate transaminase (SGPT), is an enzyme involved in the metabolism of amino acids. It is found in numerous organs and tissues with the highest levels in the kidneys and liver. ALT is released into the bloodstream as a result of tissue damage and in a variety of diseases involving the liver, such as hepatitis, cirrhosis, and mononucleosis.

V. Intended Use

  • A. Intended Use
    The CARESIDE® ALT cartridge is intended for in vitro diagnostic use in conjunction with the CARESIDE® Analyzer to quantitatively measure ALT activity in anti-coagulated whole blood, plasma, or serum.

  • B. Indications for Use
    For in vitro diagnostic use with the CARESIDE Analyzer to quantitatively measure ALT from anti-coagulated whole blood, plasma, or serum specimens to aid in the diagnosis and treatment of patients with certain types of liver and heart disease.

3

،

VI. Technological Characteristics

  • A. Similarities
CARESIDE ALTVitros ALT DT Slides
Intended UseFor in vitro diagnostic use.For in vitro diagnostic use
IndicationsPrimarily to aid in the
diagnosis and treatment of
patients with certain types of
liver and heart disease.Same
MeasurementQuantitativeSame
Method
PrincipleDry film based quantitation of
enzymatic activity by
reflectance photometry using
POP/POD coupling of ALT
catalyzed generation of
pyruvateDry film based. LDH
coupling of ALT catalyzed
generation of pyruvate.
Specimen
DilutionNot requiredSame
MaterialsL-alanine, α-ketoglutaric
acid, phosphoric acid,
pyruvate oxidase, peroxidase
and diarylimidazole leuco
dye.Lactate deydrogenase, L-
alanine, sodium α-
ketoglutarate, nicotinamide
adenine dinucleotide reduced,
and sodium pyridoxal-5-
phosphate.
DetectorReflectance (655 nm)Reflectance (340 nm)
Test TimeApprox. 4-minute warm-up
(on-board) plus 4 minute test
time.15 minutes slide warm-up
(off-line) plus 5 minutes test
time.
Reference
MethodNADH/NAD coupled
reduction of pyruvate by
lactate dehydrogenaseIFCC, 1978
Sample TypeAnti-coagulated whole blood,
plasma, or serumSame
Specimen
Volume8.5µl test volume
(90 ± 10 µl applied volume)10 µl
CalibrationCalibration information bar-
coded on each cartridge.
Calibration information may
change with lot.Run Vitros DT II calibrators
whenever a new slide lot is
used or when necessary.
Quality
Control2 levelsSame
Reporting
UnitsU/LSame
Reaction
Temp.37 °CSame
CARESIDE ALTVitros ALT DT Slides
Specimen
Pre-
treatmentNot RequiredSame
Reportable
Range15 – 1000 U/L3 – 950 U/L
Accurate
PipettingNot requiredRequired
Reagent
Pre-
warmingNot requiredRequired

4

April 30, 2002

B. Differences

  • C. Comparative Performance Characteristics
CARESIDE ALTVitros ALT DT Slides
Detection
limit15 U/L3 U/L
Reportable
Range15 - 1000 U/L3 - 950 U/L
AccuracyMean recovery 106%Not available
PrecisionTotal CV, 22 U/L, 4.5%Total CV, 40 U/L, 9.5%
Method
ComparisonCARESIDE® = 0.98 (BM/Hitachi 902) + 4.75 U/L, r =
1.00
LinearityLinearity by mixing yielded
slope and correlation
coefficient within acceptable
limitsNot available
InterferenceNo significant interference
observed at tested
concentration of interferent:
Ascorbic Acid, 10 mg/dL
Bilirubin, 20 mg/dL
Triglycerides 3000 mg/dL
Gamma globulin 4200 mg/dLHigh gamma globulin

D. Conclusion

The nonclinical and clinical data provided demonstrate that the CARESIDE ALT product is as safe, effective, and performs as well as or better than the legally marketed predicate device.

5

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/5/Picture/1 description: The image shows the logo for the Department of Health & Human Services USA. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" arranged around the perimeter. Inside the circle is a stylized image of three human profiles facing right, with flowing lines connecting them.

Re:

Food and Drug Administration 2098 Gaither Road Rockville MD 20850

Renate A. MacLauren, Ph.D. Clinical Affairs Manager Careside 6100 Bristol Parkway Culver City, CA 90230

JUN 0 4 2002

K020487 Trade/Device Name: Careside® ALT Regulation Number: 21 CFR 862.1030 Regulation Name: Alanine amino transferase (ALT/SGPT) test system Regulatory Class: Class I, reserved Product Code: CKA Dated: April 30, 2002 Received: May 2, 2002

Dear Dr. MacLauren:

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.

6

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 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 ' 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, please 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 International and Consumer Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its internet address "http://www.fda.gov/cdrb/dsma/dsmamain.html".

Sincerely yours.

Steven Putman

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

7

CARESIDE ALT Premarket Notification January 30, 2002

January 30, 2002

VI. INDICATIONS FOR USE

510(k) Number:

Device Name:

CARESIDE® ALT

KO20487

Indications for use: For in vitro diagnostic use with the CARESIDE Analyzer to quantitatively measure ALT from anti-coagulated whole blood, plasma, or serum specimens to aid in the diagnosis and treatment of patients with certain types of liver and heart disease

ean Cooper

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

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

Concurrence of CDRH, Office of Device Evaluation (ODE)


Prescription Use

(Per 21 CFR 801.109)

OR

Over-The-Counter Use (Optional Format 1-2-96)