(58 days)
PASCO MIC AND MIC/ID PANELS are used for quantitatively measuring (with the exception of the Breakpoint/ID panel which provides qualitative measurement or category results) the susceptibility of rapidly growing aerobic and facultative anaerobic bacterial pathogens to a battery of antimicrobial agents and determining the biochemical identification of those organisms. This 510(k) notification is for the addition of the antimicrobial Linezolid at concentrations of 0.25 - 8 mcg/ml to Pasco Panels. Linezolid has been shown to be active in vitro against most strains of microorganisms listed below, as described in the FDA-approved package insert for this antimicrobic. Active In Vitro and in Clinical Infectious Against: Aerobic Gram-positive microorganisms Enterococcus faecium (vancomycin-resistant strains only) Staphylococcus aureus (including methicillin-resistant strains) Active In Vitro but their clinical significance is unknown Aerobic Gram-positive microorganisms Enterococcus faecalis (including vancomycin-resistant strains) Enterococcus faecium (vancomycin-susceptible strains) Staphylococcus epidermidis (including methicillin-resistant strains) Staphylococcus haemolyticus
Pasco Panels are used for quantitatively measuring the susceptibility of rapidly growing aerobic and facultative anaerobic bacterial pathogens to a battery of antimicrobial agents and determining the biochemical identification of those organisms. Varying concentrations of antimicrobial agents (usually in two-fold dilutions) are dispensed into the Pasco microdilution panels and the panels are then frozen. Panels are thawed prior to use, inoculated with the test organisms, incubated the traditional 16-24 hours and panels are then observed for visible growth or color changes as described in the package insert. The lowest concentration of each antimicrobial agent with no apparent visible growth of the test organism is recorded as the minimum inhibitory concentration (MIC). Changes in pH and production of specific metabolites from growth in biochemical substrates are interpreted as described in the package insert for conventional tubed media.
Here's an analysis of the provided 510(k) summary regarding the PASCO MIC and MIC/ID Panels for Linezolid, structured to address your specific questions:
1. A table of acceptance criteria and the reported device performance
The document doesn't explicitly state quantitative acceptance criteria in a dedicated section. However, based on the conclusions and terminology used, the implicit acceptance criteria for this type of device (Antimicrobial Susceptibility Test) are high levels of "Essential Agreement" (EA) and "Category Agreement" (CA), and the absence of "very major," "major," or "minor" errors. Reproducibility is also a key criterion.
| Acceptance Criteria (Implicit) | Reported Device Performance |
|---|---|
| Essential Agreement (EA) | 99.9% |
| Category Agreement (CA) | 100% |
| Very Major Errors (VM) | 0 |
| Major Errors (M) | 0 |
| Minor Errors (m) | 0 |
| Reproducibility (Inter-site) | 100% |
| Reproducibility (Intra-site) | 100% |
| QC Endpoints for NCCLS organisms | Acceptable |
2. Sample size used for the test set and the data provenance
- Sample Size for Test Set:
- 413 challenge and clinical Staphylococcus spp.
- 365 challenge and clinical Enterococcus spp.
- For reproducibility testing: 10 organisms at each of 3 sites, tested in triplicate on 3 separate days (10 organisms * 3 sites * 3 days * 3 replicates = 270 individual tests for reproducibility).
- Data Provenance:
- The data includes "Challenge strains, fresh clinical isolates, stock clinical isolates and QC strains."
- Testing was conducted at "three test sites."
- The document does not specify the country of origin, but given the FDA submission, it's presumed to be within the US or compliant with US regulatory standards.
- The study appears to be prospective for the clinical isolates, as they were tested concurrently with both the Pasco methodology and reference methodology. Stock and challenge strains would also be part of a prospectively planned study.
3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts
This information is not provided in the summary. For Antimicrobial Susceptibility Testing (AST) devices, the ground truth is typically established by a recognized reference method (e.g., broth microdilution or agar dilution as per CLSI/NCCLS standards) rather than individual expert adjudication of results. The document states, "Challenge strains, fresh clinical isolates, stock clinical isolates and QC strains were tested concurrently using both Pasco methodology and reference methodology." The reference methodology serves as the ground truth.
4. Adjudication method for the test set
There was no human adjudication described for the test set results in the way one might see for imaging or pathology studies. Instead, the device's results were directly compared against a "reference methodology." The agreement percentages (EA, CA) and error rates (VM, M, m) indicate a direct comparison and calculation rather than an adjudicated consensus.
5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance
No, a multi-reader multi-case (MRMC) comparative effectiveness study was not done. This type of study is typically relevant for interpretative diagnostic devices where human reading is involved and the device provides assistance (e.g., AI in radiology). The Pasco device automates the measurement of MIC and identification, and the comparison is between the device and a reference method, not human readers. Therefore, the concept of "human readers improve with AI vs without AI assistance" does not apply here.
6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done
Yes, a standalone performance evaluation was conducted. The Pasco device, described as giving specific quantitative MIC values and biochemical identification, is itself the "algorithm" or automated system. The reported performance metrics (EA, CA, error rates, reproducibility) are for the device's output compared to a reference standard, without human intervention in the interpretation of the device's primary output. The "human-in-the-loop" here would be laboratory personnel performing the setup and reading of the reference methodology and interpreting the final results for patient care, but the device's performance itself is standalone.
7. The type of ground truth used
The ground truth used was a reference methodology for antimicrobial susceptibility testing. The document states, "Challenge strains, fresh clinical isolates, stock clinical isolates and QC strains were tested concurrently using both Pasco methodology and reference methodology". For AST, the reference method (e.g., broth microdilution as per CLSI standards) is the gold standard for determining MICs.
8. The sample size for the training set
The document does not specify a separate training set or its sample size. This type of 510(k) submission for a diagnostic device usually focuses on verification and validation (V&V) testing (what you've termed the "test set") against a known standard. Device development (which might involve 'training' in a broad sense, especially for pattern recognition or instrument calibration) is usually internal to the manufacturer and not explicitly detailed as a 'training set' in the 510(k) summary in the same way an AI/ML model's training set would be.
9. How the ground truth for the training set was established
Since a separate "training set" with ground truth establishment is not mentioned for this type of device submission, this question is not applicable based on the provided information. The ground truth for the test set (reference methodology) is detailed above.
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②
510(k) SUMMARY
(page 1 of 3)
April 15, 2003
JUN 1 3 2003
Linda K. Dillon CONTACT PERSON: Chuck Lakel Pasco Laboratories 12750 West 42nd Avenue Wheat Ridge, Co 80033 303-423-9504 TRADE NAME OF DEVICE: Pasco MIC and MIC/ID Panels Antimicrobial Susceptibility Test COMMON NAME: Class II Antimicrobial Susceptibility Test CLASSIFICATION NAME: Microbiology Panel #83
SUBSTANTIAL EQUIVALENCE:
DATE:
In review of previous 510(k) notifications for the Pasco MIC and MIC/ID panel: K011116. April 24, 2001 RE: ESBL Confirmatory Test; K010508, April 23, 2001 RE: ESBL Screen Test; K020331, March 20, 2002 RE: Ertapenem; K001953, August 10, 2000 RE: Amoxicillin; K001887, August 9, 2000 RE: Ampicillin; K001721, August 4, 2000 RE: Clarithromycin; K001612, July 18, 2000 RE: Linezolid; K001516, July 12, 2000 RE: Moxifloxacin: K992853, November 4, 1999 RE: Cefdinir; K992726, November 3, 1999 RE: Synercid (non-fastidious); K992717, November 2, 1999 RE: Synercid: K992646. October 19, 1999 RE: Penicillin: K992647, October 19, 1999 RE: Ervthromycin; K992593, October 14, 1999 RE: Chloramphenicol; K992562, October 13, 1999 RE: Ceftriaxone: K992568, October 14, 1999 RE: Cefotaxime: K992507, October 18, 1999 RE: Trovafloxacin; K992546, October 12, 1999 RE: Meropenem; K992420, September 27, 1999 RE: Sparfloxacin: K992296, September 21, 1999 RE: Vancomycin: K992297, September 3, 1999 RE: Levofloxacin; K992143, September 16, 1999 RE: Clindamycin; K992108, September 3, 1999 RE: Cefepime; K992076, August 30, 1999 RE: Cefuroxime: K992059, August 30, 1999 RE: Imipenem; K992077, September 3, 1999 RE: Ofloxacin; K991925, August 20, 1999 RE: Amoxicillin/Clavulanic Acid; and K946126, January 17, 1995 RE: Detection of resistant pneumococci), the FDA has determined the Pasco panels to be substantially equivalent to devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments.
The term "substantial equivalence" as used in this 510(k) notification is limited to the definition of substantial equivalence as found in the Federal Food, Drug, and Cosmetic Act, as amended and as applied under 21 CFR 807, Subpart E under which a device can be marketed without pre-market approval or reclassification. A determination of
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510(k) SUMMARY (page 2 of 3)
substantial equivalency under this notification is not intended to have any bearing whatsoever on the resolution of patent infringement suits or any other patent matters. No statements related to, or in support of, substantial equivalence herein shall be construed as an admission against interest under the US Patent Laws or their application by the courts.
DESCRIPTION OF THE DEVICE:
Pasco Panels are used for quantitatively measuring the susceptibility of rapidly growing aerobic and facultative anaerobic bacterial pathogens to a battery of antimicrobial agents and determining the biochemical identification of those organisms. Varying concentrations of antimicrobial agents (usually in two-fold dilutions) are dispensed into the Pasco microdilution panels and the panels are then frozen. Panels are thawed prior to use, inoculated with the test organisms, incubated the traditional 16-24 hours and panels are then observed for visible growth or color changes as described in the package insert.
The lowest concentration of each antimicrobial agent with no apparent visible growth of the test organism is recorded as the minimum inhibitory concentration (MIC). Changes in pH and production of specific metabolites from growth in biochemical substrates are interpreted as described in the package insert for conventional tubed media.
INTENDED USE FOR THE PASCO MIC AND MIC/ID PANELS:
PASCO MIC AND MIC/ID PANELS are used for quantitatively measuring (with the exception of the Breakpoint/ID panel which provides qualitative measurement or category results) the susceptibility of rapidly growing aerobic and facultative anaerobic bacterial pathogens to a battery of antimicrobial agents and determining the biochemical identification of those organisms.
SUMMARY/CONCLUSION OF SUBSTANTIAL EQUIVALENCE TESTING: Challenge strains, fresh clinical isolates, stock clinical isolates and OC strains were tested concurrently using both Pasco methodology and reference methodology in panels contained Linezolid at concentrations ranging from 0.25 - 8 mcg/ml. Testing was conducted at three test sites.
Test results of 413 challenge and clinical Staphylococcus spp. and 365 challenge and clinical Enterococcus spp. demonstrated an Essential Agreement (EA) of 99.9%. Category agreement (CA) was 100% with no very major (VM), major (M) or minor errors observed.
QC endpoints for the NCCLS recommended OC organisms (S. aureus ATCC 29213 and E. faecalis ATCC 29212) from panels using both the reference and test methodology were acceptable.
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510(k) SUMMARY (page 3 of 3)
Reproducibility testing of 10 organisms at each site on three separate days in triplicate demonstrated inter-site reproducibility of MIC results of 100%. Intra-site reproducibility of MIC results was 100% for all sites as well.
The results of the clinical testing, reproducibility testing and QC performance testing supports Substantial Equivalence as outlined in the FDA document "Class II Special Controls Guidance Document: Antimicrobial Susceptibility Test (AST) Systems; Guidance for Industry and FDA.
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DEPARTMENT OF HEALTH & HUMAN SERVICES
Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized caduceus, which is a symbol of medicine and healing. The caduceus is depicted as a stylized design with three wavy lines. The logo is surrounded by a circular border with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" written around it.
Food and Drug Administration 2098 Gaither Road Rockville MD 20850
JUN 1 3 2003
Ms. Linda K. Dillon R&D Manager BD Diagnostics Systems Pasco Laboratories 12750 W. 42nd Avenue Wheat Ridge, CO 80033-2440
K031205 Re:
Trade/Device Name: PASCO MIC and MIC/ID Panels Linezolid, 0.25-8 µg/ml Regulation Number: 21 CFR 866.1640 Regulation Name: Antimicrobial Susceptibility Test Regulatory Class: Class II Product Code: JWY Dated: April 15, 2003 Received: May 14, 2003
Dear Ms. Dillon:
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. Iisting 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.
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).
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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
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Page 1 of 1
510(k) Number (if known): K031205
Device Name: PASCO MIC and MIC/ID Panels
Indications For Use: Inclusion of Linezolid
Pasco MIC and MIC/ID panels are used for quantitatively measuring (with the exception of the Breakpoint/ID panel which provides qualitative measurement of category results) the susceptibility of rapidly growing aerobic and facultative anaerobic bacterial pathogens to a battery of antimicrobial agents and determining the biochemical identification of those organisms.
This 510(k) notification is for the addition of the antimicrobial Linezolid at concentrations of 0.25 - 8 mcg/ml to Pasco Panels. Linezolid has been shown to be active in vitro against most strains of microorganisms listed below, as described in the FDA-approved package insert for this antimicrobic.
Active In Vitro and in Clinical Infectious Against:
Aerobic Gram-positive microorganisms
Enterococcus faecium (vancomycin-resistant strains only) Staphylococcus aureus (including methicillin-resistant strains)
Active In Vitro but their clinical significance is unknown
Aerobic Gram-positive microorganisms
Enterococcus faecalis (including vancomycin-resistant strains) Enterococcus faecium (vancomycin-susceptible strains) Staphylococcus epidermidis (including methicillin-resistant strains) Staphylococcus haemolyticus
Division Sign-Off
Office of In Vitro Diagnostic Device Evaluation and Safety
510(k)_()3/205
(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)
Concurrence of CDRH, Office of Device Evaluation (ODE)
OR
Prescription Use
(Per 21 CRF 801.109) ✓
Over-The-Counter Use (Optional Format 1-2-96)
§ 866.1640 Antimicrobial susceptibility test powder.
(a)
Identification. An antimicrobial susceptibility test powder is a device that consists of an antimicrobial drug powder packaged in vials in specified amounts and intended for use in clinical laboratories for determining in vitro susceptibility of bacterial pathogens to these therapeutic agents. Test results are used to determine the antimicrobial agent of choice in the treatment of bacterial diseases.(b)
Classification. Class II (performance standards).