K Number
K022693
Device Name
INSTANT-VIEW TCA URINE TEST
Date Cleared
2002-12-09

(118 days)

Product Code
Regulation Number
862.3910
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
This device is a one-step immunoassay intended to provide qualitative rapid detection of tricyclic antidepressants (TCA) at a cutoff level of 1000 ng/ml in human urine. It is for health care professional use only. It is for health care professional, in-vitro diagnostic use only. This device is a one-step immunoassay intended to provide qualitative rapid detection of tricyclic antidepressants (TCA) at a cutoff concentration of 1,000 ng/ml in human urine. It is for health care professional use only. Instant-View™ TCA Urine Test provides only a preliminary analytical test result. A more specific alternate chemical method must be used in order to obtain a confirmed analytical result. Gas Chromatography/Mass Spectrometry (GC/MS) is the preferred confirmatory method. Clinical consideration and professional judgment should be applied to any drug of abuse test result, particularly when preliminary positive results are used.
Device Description
A one-step lateral flow chromatographic immunoassay. The test strip in the device includes 1) a conjugate pad containing colloidal gold coupled with mouse anti-TCA antibodies; 2) nitrocellulose membrane containing a test line (T line) and a control line (C line). The Test line is coated with TCA- BSA, and the Control line is coated with goat anti-mouse IgG antibody.
More Information

Not Found

No
The device description and performance studies describe a standard immunoassay with no mention of AI/ML components or methodologies.

No
The device is an immunoassay for rapid detection of tricyclic antidepressants (TCA) in human urine, providing a preliminary analytical test result. It is for in-vitro diagnostic use and does not claim to treat, mitigate, prevent, or cure any disease or condition.

Yes

Explanation: The device is intended for the "qualitative rapid detection of tricyclic antidepressants (TCA) [...] in human urine", which makes it a diagnostic device. The text also explicitly states "in-vitro diagnostic use only".

No

The device description clearly outlines a physical immunoassay test strip with specific components (conjugate pad, nitrocellulose membrane, test line, control line). This indicates a hardware-based device, not a software-only one.

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

Here's why:

  • Explicit Statement: The "Intended Use / Indications for Use" section explicitly states: "It is for health care professional, in-vitro diagnostic use only."
  • Nature of the Test: The device performs a test on a biological sample (human urine) outside of the body to detect a substance (tricyclic antidepressants). This is the core definition of an in vitro diagnostic test.
  • Intended Use: The intended use is to provide a qualitative rapid detection of TCA in human urine, which is a diagnostic purpose.

The other information provided, such as the device description, performance studies, and predicate device, further supports that this is an IVD.

N/A

Intended Use / Indications for Use

This device is a one-step immunoassay intended to provide qualitative rapid detection of tricyclic antidepressants (TCA) at a cutoff level of 1000 ng/ml in human urine. It is for health care professional use only.

It is for health care professional, in-vitro diagnostic use only.

This device is a one-step immunoassay intended to provide qualitative rapid detection of tricyclic antidepressants (TCA) at a cutoff concentration of 1,000 ng/ml in human urine. It is for health care professional use only.

Instant-View™ TCA Urine Test provides only a preliminary analytical test result. A more specific alternate chemical method must be used in order to obtain a confirmed analytical result. Gas Chromatography/Mass Spectrometry (GC/MS) is the preferred confirmatory method. Clinical consideration and professional judgment should be applied to any drug of abuse test result, particularly when preliminary positive results are used.

Product codes

MLK

Device Description

A one-step lateral flow chromatographic immunoassay. The test strip in the device includes 1) a conjugate pad containing colloidal gold coupled with mouse anti-TCA antibodies; 2) nitrocellulose membrane containing a test line (T line) and a control line (C line). The Test line is coated with TCA- BSA, and the Control line is coated with goat anti-mouse IgG antibody.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

human urine

Indicated Patient Age Range

Not Found

Intended User / Care Setting

health care professional, Physician's Office Laboratories (POL), reference 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

The accuracy of the device was evaluated with 80 clinical urine samples calibrated with GC/MS. The negative results agreed 96.7% (58/60). The positive results agreed 100% (20/20). The overall accuracy was 97.5%.

The reproducibility of this device was studied at three Physician's Office Laboratories (POL) and one reference laboratory. Evaluations were performed by personnel with diverse educational backgrounds and working experiences.

Instant-View™ TCA Urine Test has positive responses to structurally related compounds, Amitriptyline, Desipramine, Imipramine, Nortriptyline, and Nordoxepine, at a concentration of 1000 ng/ml; to Cyclobenzaprine, Protriptyline, and Trimipramine at a concentration higher than 1500 ng/ml; to Doxepine and Clomipramine at a concentration higher than 3000 ng/ml. No significant interference observed with this device by the structurally unrelated compounds tested at a concentration of 1 mg/ml.

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

Accuracy studies: The accuracy of the device was evaluated with 80 clinical urine samples calibrated with GC/MS. The negative results agreed 96.7% (58/60). The positive results agreed 100% (20/20). The overall accuracy was 97.5%.
Reproducibility studies: The reproducibility of this device was studied at three Physician's Office Laboratories (POL) and one reference laboratory. The results from the four evaluation sites agreed 99%, indicating a high reproducibility of the device.
Specificity studies: Instant-View™ TCA Urine Test has positive responses to structurally related compounds, Amitriptyline, Desipramine, Imipramine, Nortriptyline, and Nordoxepine, at a concentration of 1000 ng/ml; to Cyclobenzaprine, Protriptyline, and Trimipramine at a concentration higher than 1500 ng/ml; to Doxepine and Clomipramine at a concentration higher than 3000 ng/ml. No significant interference observed with this device by the structurally unrelated compounds tested at a concentration of 1 mg/ml.

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

Negative results agreed 96.7% (58/60).
Positive results agreed 100% (20/20).
Overall accuracy was 97.5%.
Reproducibility: The results from the four evaluation sites agreed 99%.

Predicate Device(s)

K981605

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).

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K02-693

510(K) Summary

DEC 0 9 2002 510(k) Summary of

Safety and Effectiveness as Required by 21 CFR 807.92

Name:Alfa Scientific Designs, Inc.
SubmitterAddress:
Contact Person:
E-mail:12330 Stowe Drive
Poway, CA 92064
Telephone: (858) 513-3888
Fax: (858) 513-8388
Naishu Wang, MD, Ph.D.
wnss@alfascientific.com
Device NameTrade Name: Instant-View™ TCA Urine Test
Common Name: Immunoassay, TCA Urine Test
Classification: Tricyclic antidepressant drugs test system
(21 CFR 862.3910) Class II
Date of Summary
PreparationNovember, 5, 2002
Predicate DeviceSureStep™ Drug Screen TCA Test, Applied Biotech, Inc.,
K981605
Device DescriptionA one-step lateral flow chromatographic immunoassay. The
test strip in the device includes 1) a conjugate pad containing
colloidal gold coupled with mouse anti-TCA antibodies; 2)
nitrocellulose membrane containing a test line (T line) and a
control line (C line). The Test line is coated with TCA- BSA,
and the Control line is coated with goat anti-mouse IgG
antibody.
Summary of the
Similarity to the
Predicate Device• Both are one-step lateral-flow chromatographic
immunoassay.
• Both are intended to provide qualitative detection of
Tricyclic Antidepressants at 1000 ng/ml, the cutoff level.
• Both are based on the similar mechanism of competitive
binding immunoassay.
• Both use a C line as built-in control to indicate that an
appropriate volume of sample is applied and whether the
device functions properly
• Both provide a preliminary result and need to be confirmed
with a more solid reference method, e.g. GC/MS or HPLC.
Intended UseThis device is a one-step immunoassay intended to provide
qualitative rapid detection of tricyclic antidepressants (TCA)
at a cutoff level of 1000 ng/ml in human urine. It is for health
care professional use only.
Accuracy studiesThe accuracy of the device was evaluated with 80 clinical
urine samples calibrated with GC/MS. The negative results
agreed 96.7% (58/60). The positive results agreed 100%
(20/20). The overall accuracy was 97.5%.
Reproducibility
studiesThe reproducibility of this device was studied at three
Physician's Office Laboratories (POL) and one reference
laboratory. Evaluations were performed by personnel with
diverse educational backgrounds and working experiences.
The results from the four evaluation sites agreed 99%,
indicating a high reproducibility of the device.
Specificity studiesInstant-View™ TCA Urine Test has positive responses to
structurally related compounds, Amitriptyline, Desipramine,
Imipramine, Nortriptyline, and Nordoxepine, at a
concentration of 1000 ng/ml; to Cyclobenzaprine,
Protriptyline, and Trimipramine at a concentration higher than
1500 ng/ml; to Doxepine and Clomipramine at a
concentration higher than 3000 ng/ml. No significant
interference observed with this device by the structurally
unrelated compounds tested at a concentration of 1 mg/ml.
ConclusionThe results of accuracy, reproducibility, and specificity
studies demonstrate that the Instant-View™ TM TCA Urine Test is
substantially equivalent to the legally marketed test.

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DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/2/Picture/1 description: The image shows the seal for the Department of Health & Human Services, USA. The seal is circular and contains the text "DEPARTMENT OF HEALTH & HUMAN SERVICES, USA" around the perimeter. In the center of the seal is an abstract symbol that resembles three curved lines or waves.

DEC 0 9 2002

098 Gaither Road Rockville MD 20850

Naishu Wang, M.D., Ph.D. President Alfa Scientific Designs, Inc. 12330 Stowe Drive Poway, California 92064

Re: K022693

Trade/Device Name: Instant-View™ TCA Urine Test Regulation Number: 21 CFR § 862.3910 Regulation Name: Tricyclic antidepressant drugs test system Regulatory Class: II Product Code: MLK Dated: November 6, 2002 Received: November 12, 2002

Dear Dr. Wang :

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 Title 21, Code of Federal Regulations (CFR). Parts 800 to 895. In addition, FDA may publish further announcements concerning your device in the Federal Register.

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Page 2

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 Parts 801 and 809); and good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21. CFR Part 820). This letter will allow you to begin marketing your device as described in your Section 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 information about the application of labeling requirements to your device, or questions on the promotion and advertising of your device, please contact the Office of In Vitro Diagnostic Device Evaluation and Safety at (301) 594-3084. Also, please note the regulation entitled. "Misbranding by reference to premarket notification" (21CFR Part 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 Sutman

Steven I. Gutman, M.D., M.B.A. Director Office of In Vitro Diagnostic Device Evaluation and Safety Center for Devices and Radiological Health

Enclosure

4

510(K) NUMBER (IF KNOWN) :

DEVICE NAME : Instant-View™ TCA Urine Test

INDICATIONS FOR USE:

It is for health care professional, in-vitro diagnostic use only.

This device is a one-step immunoassay intended to provide qualitative rapid detection of tricyclic antidepressants (TCA) at a cutoff concentration of 1,000 ng/ml in human urine. It is for health care professional use only.

Instant-View™ TCA Urine Test provides only a preliminary analytical test result. A more specific alternate chemical method must be used in order to obtain a confirmed analytical result. Gas Chromatography/Mass Spectrometry (GC/MS) is the preferred confirmatory method. Clinical consideration and professional judgment should be applied to any drug of abuse test result, particularly when preliminary positive results are used.

(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)

Sean Cooper

(Division Sign-Off) Division of Clinical Laboratory D 51'0(k) Number