K Number
K021526
Device Name
ACON TCA ONE STEP TRICYCLIC ANTIDEPRESSANT TEST STRIP AND DEVICE
Date Cleared
2002-07-17

(68 days)

Product Code
Regulation Number
862.3910
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The ACON TCA One Step Tricyclic Antidepressants Test Strip and ACON TCA One Step Tricyclic Antidepressant Test Device are rapid chromatographic immunoassays for the qualitative detection of Tricyclic Antidepressants in human urine at a cut-off concentration of 1,000 ng/mL in reference to Nortriptyline. They are intended for Healthcare professionals including professionals at the point-of-care sites.
Device Description
The ACON TCA One Step Tricyclic Antidepressant Test Strip and ACON TCA One Step Tricyclic Antidepressant Test Device are competitive binding, lateral flow immunochromatographic assays for the qualitative screening of Tricyclic Antidepressant in a urine sample. The test is based on the principle of antigen-antibody immuncchemistry. It utilizes mouse monoclonal antibody to selectively detect elevated levels of Tricyclic Antidepressant in urine at a cut-off concentration of 1000 ng/mL for Nortriptyline. These tests can be performed without the use of an instrument. A drug-positive urine specimen will not generate a colored-line in the designated test region, while a negative urine specimen or a urine specimen containing Tricyclic Antidepressant at the concentration below the cut-off level will generate a colored-line in the test region. To serve as a procedural control. a colored-line will always appear at the control region, indicating that proper volume of specimen has been added and membrane wicking has occurred.
More Information

Not Found

No
The device description details a lateral flow immunochromatographic assay, which is a chemical reaction-based test, not a software or algorithm-based technology. There is no mention of AI, ML, image processing, or any computational analysis of the results. The interpretation is based on the presence or absence of a colored line.

No
The device is a diagnostic tool for detecting tricyclic antidepressants in urine, not a device used for therapy.

Yes

The device qualitatively detects Tricyclic Antidepressants in human urine, which provides information for the diagnosis or monitoring of a medical condition.

No

The device is a rapid chromatographic immunoassay test strip/device, which is a physical hardware component used for qualitative detection of substances in urine. It does not describe any software component.

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

Here's why:

  • Intended Use: The intended use explicitly states it's for the "qualitative detection of Tricyclic Antidepressants in human urine." This is a diagnostic test performed on a sample taken from the human body.
  • Device Description: The description details a "rapid chromatographic immunoassay" and a "competitive binding, lateral flow immunochromatographic assay" that utilizes antibodies to detect a substance in a urine sample. These are common characteristics of IVD devices.
  • Sample Type: The test is performed on "human urine," which is a biological specimen.
  • Purpose: The purpose is to detect the presence of Tricyclic Antidepressants, which is a diagnostic function related to identifying a substance in the body.
  • Performance Studies: The document includes performance studies comparing the device to a predicate device and a reference method (HPLC), which are typical requirements for demonstrating the performance of an IVD.

Therefore, based on the provided information, the ACON TCA One Step Tricyclic Antidepressants Test Strip and Test Device clearly fit the definition of an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The ACON® TCA One Step Tricyclic Antidepressant Test Strip and ACON TCA One Step Tricyclic Antidepressant Test Device are rapid chromatographic immunoassays for the qualitative detection of Tricyclic Antidepressant in urine at a cut-off concentration of 1,000 ng/mL in reference to Nortriptyline. They are intended for healthcare professionals at point-of-care sites.

Product codes

LFG

Device Description

The ACON TCA One Step Tricyclic Antidepressant Test Strip and ACON TCA One Step Tricyclic Antidepressant Test Device are competitive binding, lateral flow immunochromatographic assays for the qualitative screening of Tricyclic Antidepressant in a urine sample. The test is based on the principle of antigen-antibody immuncchemistry. It utilizes mouse monoclonal antibody to selectively detect elevated levels of Tricyclic Antidepressant in urine at a cut-off concentration of 1000 ng/mL for Nortriptyline. These tests can be performed without the use of an instrument.

A drug-positive urine specimen will not generate a colored-line in the designated test region, while a negative urine specimen or a urine specimen containing Tricyclic Antidepressant at the concentration below the cut-off level will generate a colored-line in the test region. To serve as a procedural control. a colored-line will always appear at the control region, indicating that proper volume of specimen has been added and membrane wicking has occurred.

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

Healthcare professionals at point-of-care sites.

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

A clinical evaluation was conducted using 226 clinical urine specimens including over 10% of the samples with Antidepressants concentrations at -25% cut-off to +25% cut-off range. This evauation compared the test results between ACON® TCA One Step Tricyclic Antidepressants Test Strip and Test Device with Status DS™ One Step Tricyclic Antidepressants Test; as well as against data obtained from the customary HPLC analysis.

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

A clinical evaluation was conducted using 226 clinical urine specimens including over 10% of the samples with Antidepressants concentrations at -25% cut-off to +25% cut-off range. This evauation compared the test results between ACON® TCA One Step Tricyclic Antidepressants Test Strip and Test Device with Status DS™ One Step Tricyclic Antidepressants Test; as well as against data obtained from the customary HPLC analysis. The comparisons of data obtained from this study yielded the following results:

ACON TCA One Step Tricyclic Antidepressant Test Strip versus the Status DSTM One Step Tricyclic Antidepressants Test:
Positive Agreement: 55 / 58 = 95% (86% - 99%) Negative Agreement: 164 / 164 = 100% (98% - 99%) Overall Agreement: 219 / 222 = 99% (96% - 99 %*) * 95% Confidence Intervals

ACON TCA One Step Tricyclic Antidepressant Test Device versus the Status DSTM One Step Tricyclic Antidepressant Test:
Positive Agreement: 55 / 58 = 95% (86% - 99%) Negative Agreement: 164 / 164 = 100% (98% - 99%) Overall Agreement: 219 / 222 = 99% (96% - 99 %*) * 95% Confidence Intervals

ACON TCA One Step Tricyclic Antidepressant Test Strip versus HPLC at the cutoff of 1,000 ng/ml:
Negative agreement: 89% (84% - 93%)*
Positive agreement: >99% (90% - 99%)*

ACON TCA One-Step Tricyclic Antidepressant Test Device versus HPLC at the cutoff of 1,000 ng/ml:
Negative agreement: 89% (84% - 93%)*
Positive agreement: >99% (90% - 99%)*

These clinical studies demonstrate the substantial equivalency between the ACON TCA One Step Tricyclic Antidepressant Test Strip, ACON TCA One Step Tricyclic Antidepressant Test Device and the Status DSTM One Step Tricyclic Antidepressant Test, which has already being marketed in the United States. It is also demonstrated that these tests are safe and effective in detecting Tricyclic Antidepressant at a concentration of 1,000 ng/mL. The POL study demonstrated that these tests are suitable for healthcare professionals including professionals at point-of-care site.

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

See Summary of Performance Studies.

Predicate Device(s)

K980249

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 862.3910 Tricyclic antidepressant drugs test system.

(a)
Identification. A tricyclic antidepressant drugs test system is a device intended to measure any of the tricyclic antidepressant drugs in serum. The tricyclic antidepressant drugs include imipramine, desipramine, amitriptyline, nortriptyline, protriptyline, and doxepin. Measurements obtained by this device are used in the diagnosis and treatment of chronic depression to ensure appropriate therapy.(b)
Classification. Class II (special controls). A tricyclic antidepressant drugs test system is not exempt if it is intended for any use other than employment or insurance testing or is intended for Federal drug testing programs. The device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 862.9, provided the test system is intended for employment and insurance testing and includes a statement in the labeling that the device is intended solely for use in employment and insurance testing, and does not include devices intended for Federal drug testing programs (e.g., programs run by the Substance Abuse and Mental Health Services Administration (SAMHSA), the Department of Transportation (DOT), and the U.S. military).

0

SUMMARY OF 510(k) 8.

This summary of 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:

ACON Laboratories, Inc. 4108 Sorrento Valley Boulevard San Diego, California 92121

Tel .: 858-535-2030 Fax: 858-535-2038

Date:

May 8, 2002

Contact Person:

Edward Tung, Ph.D.

Product Names:

ACON® TCA One Step Tricyclic Antidepressant Test Strip

ACON® TCA One Step Tricyclic Antidepressant Test Device

Common Name:

Immunochromatographic test for the qualitative detection of Tricyclic Antidepressant in urine

Device Classification:

The ACON TCA One Step Tricyclic Antidepressant Test Strip and ACON TCA One Step Tricyclic Antidepressant Test Device are similar to other FDA-cleared devices for the qualitative detection of Tricyclic Antidepressant in urine specimens. These tests are used to provide a preliminary analytical result. Tricyclic Antidepressant test systems have been classified as Class II devices with moderate complexity. The product code for these devices is LFG and the regulation number is 862.3910.

1

Classification Name:

Tricyclic Antidepressant test system

Intended Use:

The ACON® TCA One Step Tricyclic Antidepressant Test Strip and ACON TCA One Step Tricyclic Antidepressant Test Device are rapid chromatographic immunoassays for the qualitative detection of Tricyclic Antidepressant in urine at a cut-off concentration of 1,000 ng/mL in reference to Nortriptyline. They are intended for healthcare professionals at point-of-care sites. 23-1-1-1-1

$\pi_i$

Description:

The ACON TCA One Step Tricyclic Antidepressant Test Strip and ACON TCA One Step Tricyclic Antidepressant Test Device are competitive binding, lateral flow immunochromatographic assays for the qualitative screening of Tricyclic Antidepressant in a urine sample. The test is based on the principle of antigen-antibody immuncchemistry. It utilizes mouse monoclonal antibody to selectively detect elevated levels of Tricyclic Antidepressant in urine at a cut-off concentration of 1000 ng/mL for Nortriptyline. These tests can be performed without the use of an instrument.

A drug-positive urine specimen will not generate a colored-line in the designated test region, while a negative urine specimen or a urine specimen containing Tricyclic Antidepressant at the concentration below the cut-off level will generate a colored-line in the test region. To serve as a procedural control. a colored-line will always appear at the control region, indicating that proper volume of specimen has been added and membrane wicking has occurred.

Predicate Device:

Status DSTM TCA One step Tricyclic Antidepressants Test

510(k) Number: K980249

Comparison to a Predicate Device:

A comparison of the features of the ACON TCA One Step Tricyclic Antidepressant Test Strip and ACON TCA One Step Tricyclic Antidepressant Test Device versus the Status™ One step Antidepressants Test is shown below:

  • Both tests are assays intended for the qualitative detection of Tricyclic Antidepressant in urine . samples.
  • . Both tests are intended as a screening method that provides a preliminary analytical test result.
  • . Both tests are immunochromatographic, lateral flow assays for the rapid detection of Tricyclic Antidepressant with a visual, qualitative end result.

2

  • Both tests utilize the same basic immunoassay principles that rely on antigen/ antibody . interactions to indicate a positive or negative result.
  • Both tests have a cut-off for Nortriptyline concentration of 1,000 ng/mL. .

Safety and Effectiveness Data:

Accuracy

A clinical evaluation was conducted using 226 clinical urine specimens including over 10% of the samples with Antidepressants concentrations at -25% cut-off to +25% cut-off range. This evauation compared the test results between ACON® TCA One Step Tricyclic Antidepressants Test Strip and Test Device with Status DS™ One Step Tricyclic Antidepressants Test; as well as against data obtained from the customary HPLC analysis. The comparisons of data obtained from this study yielded the following results:

ACON TCA One Step Tricyclic Antidepressant Test Strip versus the Status DSTM One Step Tricyclic Antidepressants Test:

Positive Agreement: 55 / 58 = 95% (86% - 99%) Negative Agreement: 164 / 164 = 100% (98% - 99%) Overall Agreement: 219 / 222 = 99% (96% - 99 %*) * 95% Confidence Intervals

ACON TCA One Step Tricyclic Antidepressant Test Device versus the Status DSTM One Step Tricyclic Antidepressant Test:

Positive Agreement: 55 / 58 = 95% (86% - 99%) Negative Agreement: 164 / 164 = 100% (98% - 99%) Overall Agreement: 219 / 222 = 99% (96% - 99 %*) * 95% Confidence Intervals

ACON TCA One Step Tricyclic Antidepressant Test Strip versus HPLC at the cutoff of 1,000 ng/ml:

| Acon
TCA test
strip | Drug -
free urine | +25%
cutoff | % agreement |
|---------------------------|----------------------|-----------------|--------------------------|--------------------------|-----------------|----------------------|
| Negative | 150 | 17 | 0 | 0 | 0 | 89%
(84% - 93%)* |
| Positive | 0 | 12 | 8 | 15 | 20 | >99%
(90% - 99%)* |

  • 95% Confidence Intervals

3

| Acon
TCA test
Device | Drug - free
urine | +25%
cutoff | % agreement |
|----------------------------|----------------------|-----------------|--------------------------|--------------------------|-----------------|---------------------|
| Negative | 150 | 17 | 0 | 0 | 0 | 89%
(84% - 93%)* |
| Positive | 0 | 12 | 8 | 15 | 20 | >99%
(90% 99%)* |

ACON TCA One-Step Tricyclic Antidepressant Test Device versus HPLC at the cutoff of 1,000 ng/ml:

· 95% Confidence Intervals

Conclusion:

These clinical studies demonstrate the substantial equivalency between the ACON TCA One Step Tricyclic Antidepressant Test Strip, ACON TCA One Step Tricyclic Antidepressant Test Device and the Status DSTM One Step Tricyclic Antidepressant Test, which has already being marketed in the United States. It is also demonstrated that these tests are safe and effective in detecting Tricyclic Antidepressant at a concentration of 1,000 ng/mL. The POL study demonstrated that these tests are suitable for healthcare professionals including professionals at point-of-care site.

4

Image /page/4/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo is a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" arranged around the perimeter. Inside the circle is a stylized image of an eagle with three lines representing its wings and a wavy line representing its body.

Food and Drug Administration 2098 Gaither Road Rockville MD 20850

JUL 1 7 2002

Edward Tung, Ph.D. Director of Regulatory Affairs ACON Laboratories, Inc. 4108 Sorrento Valley Blvd. San Diego, CA 92121

Re: K021526

Trade/Device Name: ACON® TCA One Step Tricyclic Antidepressants Test Strip ACON® TCA One Step Tricyclic Antidepressants Test Device Regulation Number: 21 CFR 862.3910 Regulation Name: Tricyclic antidepressant drugs test system Regulatory Class: Class II Product Code: LFG Dated: May 8, 2002 Received: May 10, 2002

Dear Dr. Tung:

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 (OS) 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 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

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K021526

INDICATIONS FOR USE 10.

510(k) Number:

Koals Ble

Device Name: ACON® TCA One Step Tricyclic Antidepressants Test Strip

ACON® TCA One Step Tricyclic Antidepressants Test Device

德 12/200

Indications for Use:

The ACON TCA One Step Tricyclic Antidepressants Test Strip and ACON TCA One Step Tricyclic Antidepressant Test Device are rapid chromatographic immunoassays for the qualitative detection of Tricyclic Antidepressants in human urine at a cut-off concentration of 1,000 ng/mL in reference to Nortriptyline. They are intended for Healthcare professionals including professionals at the point-of-care sites.

Sean Cooper

(Division Sign-Off)
Division of Clinical Laboratory Devices

Division of Clinical Laboratory Devices
510(k) Number K021526

(Please do not write below this point) Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use_ V (Per 21 CFR 801.109)

Over-The-Counter Use Or