K Number
K021535
Device Name
ADVIA CANTAUR AND ACS:180 INSULIN CALIBRATOR
Date Cleared
2002-06-27

(48 days)

Product Code
Regulation Number
862.1150
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The ACS:180 and ADVIA Centaur Insulin calibrators are used for calibrating the ACS:180 and ADVIA Centaur Insulin Immunoassays. The ACS:180 and ADVIA Centaur Insulin are sandwich, chemiluminescence immunoassay for the quantitative determination of Insulin in human serum for use on the automated analyzer marketed by Bayer Corporation. The ACS:180 and ADVIA Centaur Insulin Immunoassays can be used to aid in the diagnosis and treatment of diabetes mellitus and hypoglycemia.
Device Description
The ACS:180 and ADVIA Centaur Insulin Calibrator is a casein buffered solution containing potassium thiocyanate and sodium azide.
More Information

Not Found

No
The document describes a calibrator solution and immunoassay for quantitative determination of Insulin, with no mention of AI or ML technologies.

No
This device is a calibrator for an immunoassay, which is used for diagnostic purposes (to aid in the diagnosis and treatment of diabetes mellitus and hypoglycemia), not for direct therapy.

No

Explanation: The device described is a calibrator for an immunoassay, not the immunoassay itself or a diagnostic device. The immunoassay it calibrates is used to aid in diagnosis, but the calibrator itself does not perform diagnosis.

No

The device description explicitly states it is a "casein buffered solution containing potassium thiocyanate and sodium azide," which are chemical components, not software. The device is a calibrator for an immunoassay, which is a laboratory test involving physical reagents.

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

Here's why:

  • Intended Use: The intended use explicitly states that the ACS:180 and ADVIA Centaur Insulin Immunoassays are for the "quantitative determination of Insulin in human serum" and are used to "aid in the diagnosis and treatment of diabetes mellitus and hypoglycemia." This clearly indicates a diagnostic purpose performed on a sample taken from the human body (in vitro).
  • Device Description: The device is a "casein buffered solution containing potassium thiocyanate and sodium azide," which is a reagent used in a laboratory setting for testing.
  • Performance Studies: The document describes performance studies comparing the device to a predicate device (ST AIA-PACK IRI Calibrator Set), which is typical for IVD submissions.
  • Key Metrics: The key metrics listed (Within Run %CV, Total %CV, % Recovery vs TOSOH) are standard performance indicators for laboratory assays.

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

N/A

Intended Use / Indications for Use

The ACS:180 and ADVIA Centaur Insulin calibrators are used for calibrating the ACS:180 and ADVIA Centaur Insulin Immunoassays.

The ACS:180 and ADVIA Centaur Insulin are sandwich, chemiluminescence immunoassay for the quantitative determination of Insulin in human serum for use on the automated analyzer marketed by Bayer Corporation. The ACS:180 and ADVIA Centaur Insulin Immunoassays can be used to aid in the diagnosis and treatment of diabetes mellitus and hypoglycemia.

Product codes

75 JIT

Device Description

The ACS:180 and ADVIA Centaur Insulin Calibrator is a casein buffered solution containing potassium thiocyanate and sodium azide.

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

Substantial equivalence to the AIA-PACK IRI Calibrator Set is based on comparison of the control accuracy and precision of the ADVIA Centaur and ACS:180 to the predicate device.

Accuracy and Precision:

SystemSample IDMeanWithin Run %CVTotal %CV% Recovery vs TOSOH
AIA TOSOHLevel 114.632.73.6
AIA TOSOHLevel 248.712.12.9
AIA TOSOHLevel 3121.272.13.0
ADVIA CentaurLevel 114.782.93.1101.0
ADVIA CentaurLevel 242.852.82.788.0
ADVIA CentaurLevel 3121.822.63.3100.5
ACS:180Level 114.264.88.197.5
ACS:180Level 243.793.97.689.9
ACS:180Level 3120.583.15.999.4

Key Metrics

%CV, % Recovery

Predicate Device(s)

K903628

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 862.1150 Calibrator.

(a)
Identification. A calibrator is a device intended for medical purposes for use in a test system to establish points of reference that are used in the determination of values in the measurement of substances in human specimens. (See also § 862.2 in this part.)(b)
Classification. Class II (special controls). 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.

0

K021535

Bayer Diagnostics

ASC:180 and ADVIA Centaur Insulin Calibrator Section 2: Summary of Safety and Effectiveness

As required by 21 CFR 807.92, the following 510(k) Summary is provided:

JUN 2 7 2002

1. Submitter Information

Contact person:Kenneth T. Edds Ph.D.
Address:
511 Benedict Ave.
Tarrytown, NY 10591Bayer Diagnostics Corporation
Phone:
FAX:
e-mail:(914) 524-2446
(914) 524-2500
ken.edds.b.@bayer.com
Date Summary Prepared:April 29, 2002
2.Device Information
Proprietary Name:ADVIA Centaur and ACS:180 Insulin
Calibrator
Common Name:Calibrator for immunoassay analyte
Classification Name:
Class:
CFR:
Product Code:Calibrator §862.1150.
Class II
862.1150
75 JIT
3.Predicate Device Information
Name:ST AIA-PACK IRI Calibrator Set
Manufacturer:TOSOH Corporation
TOSOH Kyobashi Building
3-2-4 Kyobashi, Chuo-ku, Tokyo 104-0031 Japan
JapanPhone: +81-(3)-3275-1221
Fax: +81-(3)-3275-1214
510(k) Number:K903628

1

4. Device Description

The ACS:180 and ADVIA Centaur Insulin Calibrator is a casein buffered solution containing potassium thiocyanate and sodium azide.

5. Statement of Intended Use

For use in calibrating the ADVIA Centaur and ACS:180 Insulin immunoassays on the automated analyzers marketed by Bayer Corporation.

6. Summary of Technological Characteristics

The ADVIA Centaur and ACS:180 Insulin Calibrators are similar to the TOSOH Corporation AIA-PACK IRI Calibrator Set (K903628) in the indications for use, and reference method for standardization, WHO 66/304. In the ACS:180 and ADVIA Centaur Insulin calibrator a buffer base is used to replace the human serum base used in the TOSOH Corporation AIA-PACK IRI Calibrator Set.

7. Accuracy and Precision

The commercial control dose data represented in this document was generated using the calibrators for each respective insulin immunoassay.

Substantial equivalence to the AIA-PACK IRI Calibrator Set is based on comparison of the control accuracy and precision of the ADVIA Centaur and ACS:180 to the predicate device.

| System | Sample ID | Mean | Within Run
%CV | Total
%CV | % Recovery
vs TOSOH |
|---------------|-----------|--------|-------------------|--------------|------------------------|
| AIA TOSOH | Level 1 | 14.63 | 2.7 | 3.6 | |
| AIA TOSOH | Level 2 | 48.71 | 2.1 | 2.9 | |
| AIA TOSOH | Level 3 | 121.27 | 2.1 | 3.0 | |
| ADVIA Centaur | Level 1 | 14.78 | 2.9 | 3.1 | 101.0 |
| ADVIA Centaur | Level 2 | 42.85 | 2.8 | 2.7 | 88.0 |
| ADVIA Centaur | Level 3 | 121.82 | 2.6 | 3.3 | 100.5 |
| ACS:180 | Level 1 | 14.26 | 4.8 | 8.1 | 97.5 |
| ACS:180 | Level 2 | 43.79 | 3.9 | 7.6 | 89.9 |
| ACS:180 | Level 3 | 120.58 | 3.1 | 5.9 | 99.4 |

2

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circle with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" around the top half of the circle. Inside the circle is a stylized image of an eagle.

Food and Drug Administration 2098 Gaither Road Rockville MD 20850

JN 2 7 2002

Kenneth T. Edds, Ph.D. Manager, Regulatory Affairs Bayer Diagnostics 511 Benedict Avenue Tarrytown, NY 10591-5097

Re: K021535

Trade/Device Name: Bayer Diagnostics ACS:180 and ADVIA Centaur Insulin Calibrator Regulation Number: 21 CFR 862.1150 Regulation Name: Calibrator Regulatory Class: Class II Product Code: JIT Dated: May 3, 2002 Received: May 10, 2002

Dear Dr. Edds:

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.

3

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/dsmaldsmamain.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

4

Page of

510(k) Number (if known): __ K 0315 35

Device Name: Bayer Diagnostics ACS:180 and ADVIA Centaur Insulin Calibrator

Indications for Use:

The ACS:180 and ADVIA Centaur Insulin calibrators are used for calibrating the ACS:180 and ADVIA Centaur Insulin Immunoassays.

The ACS:180 and ADVIA Centaur Insulin are sandwich, chemiluminescence immunoassay for the quantitative determination of Insulin in human serum for use on the automated analyzer marketed by Bayer Corporation. The ACS:180 and ADVIA Centaur Insulin Immunoassays can be used to aid in the diagnosis and treatment of diabetes mellitus and hypoglycemia.

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use _

OR

Over-The-Counter Use

(Per 21 CFR 801.109)

(Optional Format 1-2-96)

Dean Cooper

División Sian-Off) Division of Clinical Laborator 510(k) Number .