K Number
K021484
Device Name
HEMOGLOBIN A1C CONTROL
Date Cleared
2002-06-14

(37 days)

Product Code
Regulation Number
864.7470
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Hemoglobin A1c Control contains both Normal and Abnormal level Controls. They are intended for use as a quality control material to monitor the precision of laboratory testing procedures for HbA1c quantitation.
Device Description
The Hemoglobin A1c Control contains both Normal and Abnormal level Controls. They are intended for use as a quality control material to monitor the precision of laboratory testing procedures for HbA1c quantitation. They are prepared from normal adult human blood The source blood is tested and found to be non-reactive for Hepatitis B surface antigen, Hepatitis C antibody, antibodies against human immunodeficiency virus (HIV) types 1 & 2, and Syphilis (RPR and TPHA). The Abnormal Level Control is prepared by controlled glycation of normal non-diabetic hemolysate. The controls are reconstituted with distilled water or a reconstitution solution comprising the biocide sodium azide (0.09%). The reconstitution volume is between 0.25 mL and 0.5 mL. The controls reconstitute in 15 minutes with occasional swirling, and are stored at 2° - 8°C.
More Information

Not Found

No
The 510(k) summary describes a quality control material for laboratory testing and does not mention any AI or ML components in its intended use, device description, or performance studies.

No
This device is a quality control material intended to monitor the precision of laboratory testing procedures, not to treat or prevent a disease.

No
Explanation: The device is a quality control material used to monitor the precision of laboratory testing procedures, not to diagnose a condition in a patient.

No

The device description clearly indicates the product is a physical material (human blood-based controls) used for laboratory testing, not a software application.

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

Here's why:

  • Intended Use: The intended use explicitly states it is for "monitoring the precision of laboratory testing procedures for HbA1c quantitation." This is a classic function of an IVD quality control material used in a laboratory setting.
  • Device Description: The description details the composition of the control material, its preparation from human blood, and how it is used in a laboratory setting (reconstitution, storage).
  • Predicate Device: The mention of a predicate device (Lyphochek Diabetes Control Level 1 & 2) which is also a quality control material for diabetes testing further supports its classification as an IVD.

IVDs are defined as reagents, instruments, and systems intended for use in the diagnosis of disease or other conditions, including a determination of the state of health, in order to cure, mitigate, treat, or prevent disease or its sequelae. While this specific device is a control material and not directly used for diagnosis, it is an essential component of the IVD system used for HbA1c testing, which is a diagnostic test for diabetes. Quality control materials are considered IVDs because they are used to ensure the accuracy and reliability of diagnostic tests performed in vitro.

N/A

Intended Use / Indications for Use

The Hemoglobin A1c Control contains both Normal and Abnormal level Controls. They are intended for use as a quality control material to monitor the precision of laboratory testing procedures for HbA1c quantitation.

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

LCP

Device Description

The Hemoglobin A1c Control contains both Normal and Abnormal level Controls. They are intended for use as a quality control material to monitor the precision of laboratory testing procedures for HbA1c quantitation. They are prepared from normal adult human blood The source blood is tested and found to be non-reactive for Hepatitis B surface antigen, Hepatitis C antibody, antibodies against human immunodeficiency virus (HIV) types 1 & 2, and Syphilis (RPR and TPHA). The Abnormal Level Control is prepared by controlled glycation of normal non-diabetic hemolysate. The controls are reconstituted with distilled water or a reconstitution solution comprising the biocide sodium azide (0.09%). The reconstitution volume is between 0.25 mL and 0.5 mL. The controls reconstitute in 15 minutes with occasional swirling, and are stored at 2° - 8°C.

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

laboratory

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.)

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.

K831478

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

§ 864.7470 Glycosylated hemoglobin assay.

(a)
Identification. A glycosylated hemoglobin assay is a device used to measure the glycosylated hemoglobins (A1a , A1b , and A1c ) in a patient's blood by a column chromatographic procedure. Measurement of glycosylated hemoglobin is used to assess the level of control of a patient's diabetes and to determine the proper insulin dosage for a patient. Elevated levels of glycosylated hemoglobin indicate uncontrolled diabetes in a patient.(b)
Classification. Class II (performance standards).

0

Section 11 510(k) Device Summary

510(k) SUMMARY

This summary of 510(k) safety and effectiveness information is being submitted in accordance with the requirements of SMDA 1990 and 21 CFR 807.92.

The assigned 510(k) number is ________________________________________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________________________________________________________

Submitter

Canterbury Scientific Limited 21 Wroxton Terrace Christchurch New Zealand Phone and FAX (+643) 355 5598

Contact Person Maurice Owen, Laboratory Manager, Canterbury Scientific Ltd.

Date of Preparation 03 May 2002

Hemoglobin A1c Control Device Name

Class II, LCP Classification "

Equivalent Device

Lyphochek Diabetes Control Level 1 & 2, Bio-Rad Laboratories. (510(k) = K831478)

Description of Device The Hemoglobin A1c Control contains both Normal and Abnormal level Controls. They are intended for use as a quality control material to monitor the precision of laboratory testing procedures for HbA1c quantitation.

They are prepared from normal adult human blood The source blood is tested and found to be non-reactive for Hepatitis B surface antigen, Hepatitis C antibody, antibodies against human immunodeficiency virus (HIV) types 1 & 2, and Syphilis (RPR and TPHA).

The Abnormal Level Control is prepared by controlled glycation of normal non-diabetic hemolysate.

The controls are reconstituted with distilled water or a reconstitution solution comprising the biocide sodium azide (0.09%). The reconstitution volume is between 0.25 mL and 0.5 mL. The controls reconstitute in 15 minutes with occasional swirling, and are stored at 2° - 8°C.

1

Intended Use of Device

The Hemoglobin A1c Control is intended for use as a quality control material to monitor the precision of laboratory testing procedures for HbA1c quantitation.

The use of quality control materials is indicated as an objective assessment of the precision of methods and techniques in use and is an integral part of good laboratory practices. The two levels of controls allow performance monitoring within the clinically important range.

The measurement of HbA1c is especially useful in insulindependent diabetic patients where blood glucose levels fluctuate widely and where the instantaneous blood glucose does not reflect the averaged situation. The formation of HbA1c occurs slowly (about 0.05%/day) and continuously during the 120-day lifetime of the red cell. Hence the measurement of HbA1c is useful to physicians as a long-term integral of blood glucose concentration and thus as a measure of the degree of control or self-management by the diabetic patient. The normal range for HbA1c is 4% - 6% of total hemoglobin. Each percentage point increase in HbA1c level corresponds to an increase in average blood glucose level of about 30 mg/dL or 1.7mmol/L. As a general rule HbA1c levels above 10% represent poor diabetic control, whereas values of about 7% are indicative of good control.

The controls are for in vitro diagnostic use only and should not be used past the expiry date. Thev are not intended to be used as standards or calibrants.

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| | Hemoglobin A1c Control
New Device | Lyophochek Diabetes
Control, Levels 1 and 2
Bio-Rad Laboratories |
|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------|
| 510(k) Number | | K831478 |
| Type of Product | Quality Control Product | Quality Control Product |
| Description | Lyophilized Hemoglobin Control | Lyophilized Hemoglobin Control |
| Type of Vial and Cap | 3.5mL clear borosilicate glass
vial with plastic screw cap and
phenolic moisture barrier liner. | 10 mL amber glass serum vial
with butyl rubber insert and
aluminum crimp top. |
| Intended Use | As a quality control lysate to
monitor the precision of
laboratory procedures for
measurement of HbA1c | As a quality control lysate to
monitor the precision of
laboratory procedures for
measurement of HbA1c and
HbA1 |
| Contents of Vials | Human hemoglobins (HbA,
HbA1c, HbF, HbA2),
Cryopreservative, broad
spectrum antibiotic, stabilizers. | Human hemoglobins (HbA,
HbA1c, HbF, HbA2, HbS),
preservatives, stabilizers |
| Serology Testing of Human
Source Material | Non-reactive for:
Hepatitis B Surface Antigen

Antibody to Hepatitis C

Antibody to HIV-1 & HIV-2

Syphilis (TPHA & RPR) | Non-reactive for:
● Hepatitis B Surface Antigen
● Antibody to Hepatitis C
● Antibody to HIV-1 & HIV-2
Syphilis testing status not known |
| Number of Levels | 2 (Normal and Abnormal) | 2 (Level 1 [normal] and level 2
[Abnormal]) |
| Storage | 2°-8°C | 2°-8°C |
| Stability of Lyophilized Product | 3 years at 2° - 8°C | ? 3 years at 2° - 8°C |
| Stability Reconstituted Control | 13 weeks at 2°-8°C | 7 days at 2° - 8°C |
| Reconstitution Volume | 0.25 - 0.5mL | 0.5mL |
| Moisture (Loss on Drying) | Less than 3% | Not known, but likely to be less
than 3% |
| Target Value and acceptable
range for Level 1 Composition
(For the Bio-Rad product the target
figures are not known, so a typical
range (lot 33591) is given) | 5.0% (4.5% - 6.0%) | Mean 5.1% - 5.6% (range 4.7%

  • 6.0%) for HPLC methods given
    in information sheet |
    | Target Value and acceptable
    range for Level 2 Composition
    (For the Bio-Rad product the target
    figures are not known, so a typical
    range (lot 33592) is given) | 10.5% (10.0% - 13.0%) | Mean 9.8% - 10.3% (range
    9.0% - 11.3%) for HPLC
    methods given in information
    sheet |
    | Methods Suitable for Controls | HPLC, latex
    immunoagglutination inhibition | HPLC, latex
    immunoagglutination inhibition |

Comparison of Technological Characteristics with Predicate Device

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Image /page/3/Picture/1 description: The image is a black and white logo for the U.S. Department of Health & Human Services. The logo consists of a circular border with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" arranged around the perimeter. Inside the circle is a stylized image of an eagle with three heads, each head facing a different direction. The eagle's body is represented by flowing lines.

Food and Drug Administration 2098 Garther Road Rockville MD 20850

JUN 1 4 2002

Maurice Owen. Ph.D. Laboratory Manager Canterbury Scientific Limited 21 Wroxton Terrace Christchurch 8001 New Zealand

Re: K021484

Trade/Device Name: Hemoglobin A1c Control Regulation Number: 21 CFR 864.7470 Regulation Name: Glycosylated Hemoglobin Assay Regulatory Class: Class II Product Code: LCP Dated: May 30, 2002 Received: June 3, 2002

Dear Dr. Owen:

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. Ilisting of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.

If vour 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 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 v 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/cdrh/dsma/dsmamain.html".

Sincerely yours,

Steven Butman

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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Section 10 Statement of Indications for Use

  • 10.1 Device Name
    Hemoglobin A1c Control

10.2 Indications for Use

The Hemoglobin A1c Control contains both Normal and Abnormal level Controls. They are intended for use as a quality control material to monitor the precision of laboratory testing procedures for HbA1c quantitation.

Josephine Bautier

linical Laboratory Devices 510(k) Number