K Number
K023766
Device Name
ACON STREP A TWIST TEST DEVICE
Date Cleared
2003-02-10

(90 days)

Product Code
Regulation Number
866.3740
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The ACON® Strep A Twist Rapid Test Device is a rapid chromatographic immunoassay for the qualitative detection of Strep A antigen from throat swab specimens to aid in the diagnosis of Group A Streptococcal infection. This test is indicated for professional and point of care use only.
Device Description
The ACON® Strep A Twist Rapid Test Device is a qualitative, lateral flow immunochromatographic assay for the detection of Strep A antigen from a throat swab. The test is a heterogeneous, sandwich immunoassay, based on the principle of antigen-antibody immunochemistry, which uses a mixture of polyclonal antibodies to reliably produce a visually discernible colored line in the test region if Strep A antigen is present at a concentration of roughly 2.5 x 102 organisms per swab or greater.
More Information

Not Found

No
The device description and performance studies describe a standard lateral flow immunoassay for qualitative detection, with no mention of AI or ML technologies.

No
The device is a diagnostic test for detecting Strep A antigen, not a treatment or therapy.

Yes
The device is described as "to aid in the diagnosis of Group A Streptococcal infection," which indicates its intended use is for diagnostic purposes.

No

The device description clearly states it is a "rapid chromatographic immunoassay" and a "qualitative, lateral flow immunochromatographic assay," which are hardware-based test methods. It also describes the visual detection of a colored line, indicating a physical 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 Strep A antigen from throat swab specimens to aid in the diagnosis of Group A Streptococcal infection." This is a classic definition of an in vitro diagnostic test, as it analyzes a biological sample (throat swab) outside of the body to provide information for diagnosis.
  • Device Description: The description details a "rapid chromatographic immunoassay" that detects an "antigen" from a "throat swab." This describes a laboratory-based test performed on a biological specimen.
  • Performance Studies: The performance studies involve testing the device with "specimens from 758 patients" and comparing the results to a "Strep A confirmed culture technique." This further confirms that the device is used to analyze biological samples.

The information provided clearly indicates that the ACON® Strep A Twist Rapid Test Device is designed to be used in vitro (outside the living organism) to examine a biological specimen for diagnostic purposes.

N/A

Intended Use / Indications for Use

The ACON Strep A Twist Rapid Test Device is a rapid chromatographic immunoassay for the qualitative detection of Strep A antigen from throat swab specimens to aid in the diagnosis of Group A Streptococcal infection.

The ACON® Strep A Twist Rapid Test Device is a rapid chromatographic immunoassay for the qualitative detection of Strep A antigen from throat swab specimens to aid in the diagnosis of Group A Streptococcal infection. This test is indicated for professional and point of care use only.

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

GTY

Device Description

The ACON® Strep A Twist Rapid Test Device is a qualitative, lateral flow immunochromatographic assay for the detection of Strep A antigen from a throat swab. The test is a heterogeneous, sandwich immunoassay, based on the principle of antigen-antibody immunochemistry, which uses a mixture of polyclonal antibodies to reliably produce a visually discernible colored line in the test region if Strep A antigen is present at a concentration of roughly 2.5 x 10^2 organisms per swab or greater.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Throat

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Professional & point of care use.

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 multi-center clinical evaluation was conducted with specimens from 758 patients presenting with signs and symptoms of pharyngitis. This evaluation compared the result of the ACON® Strep A Twist Rapid Test Device and another commercially available Strep A test device, the QuickVue In-Line One-Step Strep A test to the customary Strep A confirmed culture technique.

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

Accuracy
A multi-center clinical evaluation was conducted with specimens from 758 patients presenting with signs and symptoms of pharyngitis. This evaluation compared the result of the ACON® Strep A Twist Rapid Test Device and another commercially available Strep A test device, the QuickVue In-Line One-Step Strep A test to the customary Strep A confirmed culture technique.

In this study, there were a total of four invalid results, two with the Quidel product and two with the ACON product. These invalid results were excluded from the data analysis. The data from this study yielded the following results:

ACON Strep A Twist Rapid Test Device compared to QuickVue In-Line One-Step Strep A.
Positive Agreement: 130/138 = 94% (89-97)*
Negative Agreement: 375/375 = 100% (99-100)*
Overall Agreement: 505/513 = 98% (97-99)*

ACON Strep A Twist Rapid Test Device compared to Strep A confirmed Culture
Sensitivity: 240/265 = 90% (86-94)*
Specificity: 464/491 = 94% (92-96)*
Accuracy: 704/756 = 93% (91-95)*

  • Denotes 95% confidence intervals

Sensitivity
Nine (9) different strains of Strep A were evaluated with the ACON Strep A Twist Rapid Test Device. The minimum detectable level differed slightly depending upon the strain being tested. The detection level of all of the strains was roughly within one magnitude in concentration of each other. Seven (7) strains showed a minimum detectable level at roughly 10° organisms per swab while two (2) strains showed a minimum detectable level at roughly 10 organisms per swab.

In addition, the throat swab specimens from the study that yielded beta-hemolytic colony growth were assigned a semi-quantitative value expressed as rare, 1+, 2+, 3+ or 4+. The ability of the ACON Strep A Twist Rapid Test Device to detect these various concentration levels is shown below.

Culture ClassificationACON/Culture% Correct
Negative (Specificity)464/49194%
Rare4/1136%
1+16/2080%
2+17/2374%
3+26/2990%
4+175/18296%
Total Positive (Sensitivity)238/26590%
Total (Overall Agreement)702/75693%

Specificity
Specificity studies were conducted by individually spiking the various bacterial strains listed below on swabs at a final concentration of 1.0 x 10^7 org/swab, then evaluating the swabs in duplicate according to the package insert. None of the organism demonstrated any cross-reactivity in the test. The organisms tested were: Bordetella pertussis, Staphylococcus aureus, Branhamella catarrhalis, Staphylococcus epidermidis, Candida albicans, Strep B, Corynebacterium diphtheriae, Strep C, Enterococcus durans, Strep F, Enterococcus faecalis, Strep G, Hemophilus influenzae, Streptococcus mutans, Klebsiella pneumoniae, Streptococcus pneumoniae, Neisseria gonorrhea, Streptococcus sanguis, Neisseria meningitidis, Streptococcus intermedius, Neisseria sicca, Streptococcus oralis, Neisseria subflava, Streptococcus mitis, Pseudomonas aeruginosa, Streptococcus anginosus, Serratia marcescens, Escherichia coli.

Interfering Substances
No interference to an expected negative or positive result was observed in our studies when using specimens containing the following substances at a final concentration of 1% (Mucin at 1 mg/swab): Cherry Halls Cough Drops, Vicks Chloraseptic Spray, Menthol Halls Cough Drops, Cepacol Sore Throat Spray, Robitussin Cough Syrup, Listerine Mouthwash, Dimetapp Cough Elixir, Scope Mouthwash, Whole Blood at 100uL, Mucin (at 1 mg/swab).

Intra and Inter-assay Variability
Studies to evaluate inter- and inter-assay variability demonstrated that the test yielded that expected results >99% of the time.

Lot-to-Lot Variability
Studies to evaluate the manufacturability and consistency of the product on a lot-to-lot basis have shown this test to be highly reproducible.

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

Positive Agreement: 130/138 = 94% (89-97)*
Negative Agreement: 375/375 = 100% (99-100)*
Overall Agreement: 505/513 = 98% (97-99)*

Sensitivity: 240/265 = 90% (86-94)*
Specificity: 464/491 = 94% (92-96)*
Accuracy: 704/756 = 93% (91-95)*

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.

K954257

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

§ 866.3740

Streptococcus spp. serological reagents.(a)
Identification. Streptococcus spp. serological reagents are devices that consist of antigens and antisera (excluding streptococcal exoenzyme reagents made from enzymes secreted by streptococci) used in serological tests to identifyStreptococcus spp. from cultured isolates derived from clinical specimens. The identification aids in the diagnosis of diseases caused by bacteria belonging to the genusStreptococcus and provides epidemiological information on these diseases. Pathogenic streptococci are associated with infections, such as sore throat, impetigo (an infection characterized by small pustules on the skin), urinary tract infections, rheumatic fever, and kidney disease.(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 § 866.9.

0

FEB 1 0 2003

Summary of Safety and Effectiveness 7.

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: ACON Laboratories, Inc. 4108 Sorrento Valley Boulevard San Diego, California 92121 Phone: 858-535-2030 Fax: 858-535-2035

Date: October 31, 2002

Contact Person: Edward Tung, Ph.D.

Product Name: ACON® Strep A Twist Rapid Test Device

Common Name:

Immunochromatographic test for the qualitative detection of Group A Streptococcal antigen from a throat swab specimen.

Device Classification:

The ACON Strep A Twist Rapid Test Device is similar to other FDA-cleared devices for the qualitative detection of Group A Streptococcus Antigen from throat swab specimens. These tests are used to aid in the diagnosis of Group A Streptococcus infection. (21 CFR 866.3740). Serological test systems for the detection of Group A Streptococcus antigen have been classified as Class I devices.

Classification Name:

Streptococcus spp. Serological reagents

Intended Use:

The ACON Strep A Twist Rapid Test Device is a rapid chromatographic immunoassay for the qualitative detection of Strep A antigen from throat swab specimens to aid in the diagnosis of Group A Streptococcal infection.

1

Description:

The ACON® Strep A Twist Rapid Test Device is a qualitative, lateral flow immunochromatographic assay for the detection of Strep A antigen from a throat swab. The test is a heterogeneous, sandwich immunoassay, based on the principle of antigen-antibody immunochemistry, which uses a mixture of polyclonal antibodies to reliably produce a visually discernible colored line in the test region if Strep A antigen is present at a concentration of roughly 2.5 x 102 organisms per swab or greater.

Predicate Device:

Quidel QuickVue In-Line One-Step Strep A

510(k) Number K954257

Quidel Corp. 10165 McKellar Court San Diego, California 92121

Comparison to a Predicate Device:

A summary comparison of the features of the ACON Strep A Twist Rapid Test Device and the Quidel QuickVue In-Line One-Step Strep A is shown below.

FeatureACON® Strep A Twist Rapid Test DeviceQuickVue In-Line One-Step Strep A
Intended UseA rapid chromatographic immunoassay for the
qualitative detection of Strep antigens from
throat swab specimens to aid in the diagnosis
of Group A Streptococcal infection.The QuickVue In-Line One-Step Strep A
allows for the rapid detection of group A
streptococcal antigen directly from patient
throat swabs. The test is intended to use as an
aid in the diagnosis of group A streptococcal
infection.
Indications for UseProfessional & point of care use.Professional & point of care use.
Intended SpecimenThroat SwabThroat Swab
EndpointColored LinesColored Lines
Materials ProvidedTest Devices
Sterile Swabs
Extraction Reagents A & B
Positive Control (Non-viable Strep A)
Negative Control (Non-viable Strep C)
Package Insert
Procedure CardTest Cassettes
Sterile Swabs
Extraction Solution bottle
Positive Control (Heat-inactivated Strep A)
Negative Control (Heat-inactivated Strep C)
Package Insert
Procedure Card
Extraction kit for use with Proficiency Testing
samples only
MethodologyMembrane Particle AssayMembrane Particle Assay
Extraction Reagent
Color ReactionReagent A - Red Color
Reagent B - Clear Color
Combined Reagents - Yellow colorReagent inside bottle - Clear Color
Reagent inside ampoule - Clear Color
Combined Reagents - Green color
Extraction Time1 minuteup to 1 minute
Test Time5 minutes5 minutes
FormatImmunochemical, Strep A antigen /antibody,
immunoassay principleImmunochemical, Strep A antigen/antibody,
immunoassay principle
Organism detectionStrep A specificStrep A specific

2

Safety and Effectiveness Data:

Accuracy

A multi-center clinical evaluation was conducted with specimens from 758 patients presenting with signs and symptoms of pharyngitis. This evaluation compared the result of the ACON® Strep A Twist Rapid Test Device and another commercially available Strep A test device, the QuickVue In-Line One-Step Strep A test to the customary Strep A confirmed culture technique.

In this study, there were a total of four invalid results, two with the Quidel product and two with the ACON product. These invalid results were excluded from the data analysis. The data from this study vielded the following results:

ACON Strep A Twist Rapid Test Device compared to QuickVue In-Line One-Step Strep A.

Positive Agreement: 130/138 = 94% (89-97)*
Negative Agreement: 375/375 = 100% (99-100)*
Overall Agreement: 505/513 = 98% (97-99)*

ACON Strep A Twist Rapid Test Device compared to Strep A confirmed Culture

Sensitivity:
Specificity:
Accuracy:
vice compared to Strep A confirmed C
240/265 = 90% (86-94)*
464/491 = 94% (92-96)*
704/756 = 93% (91-95)*
  • Denotes 95% confidence intervals

Sensitivity

Nine (9) different strains of Strep A were evaluated with the ACON Strep A Twist Rapid Test Device. The minimum detectable level differed slightly depending upon the strain being tested. The detection level of all of the strains was roughly within one magnitude in concentration of each other. Seven (7) strains showed a minimum detectable level at roughly 10° organisms per swab while two (2) strains showed a minimum detectable level at roughly 10 organisms per swab.

In addition, the throat swab specimens from the study that yielded beta-hemolytic colony growth were assigned a semi-quantitative value expressed as rare, 1+, 2+, 3+ or 4+. The ability of the ACON Strep A Twist Rapid Test Device to detect these various concentration levels is shown below.

3

Culture ClassificationACON/Culture% Correct
Negative (Specificity)464/49194%
Rare4/1136%
1+16/2080%
2+17/2374%
3+26/2990%
4+175/18296%
Total Positive (Sensitivity)238/26590%
Total (Overall Agreement)702/75693%

Specificity

Specificity studies were conducted by individually spiking the various bacterial strains listed below on swabs at a final concentration of 1.0 x 107 org/swab, then evaluating the swabs in duplicate according to the package insert. None of the organism demonstrated any cross-reactivity in the test. The organisms tested were:

Bordetella pertussisStaphylococcus aureus
Branhamella catarrhalisStaphylococcus epidermidis
Candida albicansStrep B
Corynebacterium diphtheriaeStrep C
Enterococcus duransStrep F
Enterococcus faecalisStrep G
Hemophilus influenzaeStreptococcus mutans
Klebsiella pneumoniaeStreptococcus pneumoniae
Neisseria gonorrheaStreptococcus sanguis
Neisseria meningitidisStreptococcus intermedius
Neisseria siccaStreptococcus oralis
Neisseria subflavaStreptococcus mitis
Pseudomonas aeruginosaStreptococcus anginosus
Serratia marcescensEscherichia coli

Interfering Substances

No interference to an expected negative or positive result was observed in our studies when using specimens containing the following substances at a final concentration of 1% (Mucin at 1 mg/swab):

Cherry Halls Cough DropsVicks Chloraseptic Spray
Menthol Halls Cough DropsCepacol Sore Throat Spray
Robitussin Cough SyrupListerine Mouthwash
Dimetapp Cough ElixirScope Mouthwash
Whole Blood at 100uLMucin (at 1 mg/swab)

4

Intra and Inter-assay Variability

Studies to evaluate inter- and inter-assay variability demonstrated that the test yielded that expected results >99% of the time

Lot-to-Lot Variability

Studies to evaluate the manufacturability and consistency of the product on a lot-to-lot basis have shown this test to be highly reproducible.

Conclusion

These studies demonstrate the substantial equivalency of the ACON® Strep A Twist Rapid Test Device to the QuickVue In-Line One-Step Strep A, which is already marketed. They further demonstrate the suitability of this product for professional and point-of-care use, in addition to demonstrating its safety and effectiveness.

5

Image /page/5/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 perimeter. Inside the circle is a stylized image of three human profiles facing right, with flowing lines representing hair or clothing.

Food and Drug Administration 2098 Gaither Road Rockville MD 20850

FEB 1 0 2003

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

Re: K023766

Trade/Device Name: Acon® Strep A Twist Rapid Test Device Regulation Number: 21 CFR 866.3740 Regulation Name: Streptococcus Spp. Serological Reagents Regulatory Class: Class I Product Code: GTY Dated: November 8, 2002 Received: November 12, 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 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 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.

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).

6

Page 2 -

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

7

INDICATIONS FOR USE 9.

510(k) Number:

K023766

Device Name:

The ACON® Strep A Twist Rapid Test Device

Indications For Use:

The ACON® Strep A Twist Rapid Test Device is a rapid chromatographic immunoassay for the qualitative detection of Strep A antigen from throat swab specimens to aid in the diagnosis of Group A Streptococcal infection. This test is indicated for professional and point of care use only.

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

Prescription Use_ レ

(Per 21 CFR 801.109)

Or

Over-The-Counter Use

Freddie Jr. Pool.

(Division Sign-Off) Division of Clinical Laboratory Devices

510(k) Number KD23766