K Number
K032611
Device Name
LYPHOCHEK COAGULATION CONTROL, LEVEL 4, MODEL 743
Manufacturer
Date Cleared
2003-09-17

(23 days)

Product Code
Regulation Number
864.5425
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Lyphochek® Coagulation Control is intended for use as a quality control plasma to monitor the precision of citrated coagulation systems.
Device Description
Lyphochek® Coagulation Control is prepared from human plasma, with added purified biochemicals (tissue extract from animal origin), and preservatives. The control is provided in lyophilized form for increased stability.
More Information

Not Found

No
The summary describes a quality control material for coagulation systems, which is a biochemical product, not a software or hardware device that would typically incorporate AI/ML. The "Mentions AI, DNN, or ML" section is explicitly marked as "Not Found".

No
The device is a quality control plasma used to monitor the precision of coagulation systems, not to treat or therapeutically affect a patient's condition.

No
This device is a quality control plasma used to monitor the precision of coagulation systems, not to diagnose a condition in a patient.

No

The device description explicitly states it is prepared from human plasma and provided in lyophilized form, indicating it is a physical substance, not software.

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

Here's why:

  • Intended Use: The intended use explicitly states it's for "use as a quality control plasma to monitor the precision of citrated coagulation systems." This indicates it's used in vitro (outside the body) to assess the performance of diagnostic tests related to blood coagulation.
  • Device Description: It's prepared from human plasma and other biochemicals, and it's used in a laboratory setting to evaluate the accuracy of coagulation testing equipment.
  • Quality Control: The primary function is quality control, which is a fundamental aspect of IVD testing to ensure reliable results.

The information provided clearly aligns with the definition of an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

Lyphochek® Coagulation Control is intended for use as a quality control plasma to monitor the precision of citrated coagulation systems.

Product codes

GGN

Device Description

Lyphochek® Coagulation Control is prepared from human plasma, with added purified biochemicals (tissue extract from animal origin), and preservatives. The control is provided in lyophilized form for increased stability.

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 (study type, sample size, AUC, MRMC, standalone performance, key results)

Stability studies have been performed to determine the open vial stability and shelf life for the Lyphochek® Coagulation Control Level 4. Product claims are as follows:

  • Open vial: Once the control material is reconstituted, all analytes will be stable for 24 hours when stored tightly capped at 2-25°C
  • Shelf Life: Three years when stored at 2-8 °C
  • Real time studies will be ongoing to support the shelf life of this product.

All supporting data is retained on file at Bio-Rad Laboratories.

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

Not Found

Predicate Device(s)

K012722

Reference Device(s)

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

§ 864.5425 Multipurpose system for in vitro coagulation studies.

(a)
Identification. A multipurpose system for in vitro coagulation studies is a device consisting of one automated or semiautomated instrument and its associated reagents and controls. The system is used to perform a series of coagulation studies and coagulation factor assays.(b)
Classification. Class II (special controls). A control intended for use with a multipurpose system for in vitro coagulation studies is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 864.9.

0

SEP 17 2003

K032611

Page 1 of 2

Summary of Safety and Effectiveness Lyphochek® Coagulation Control Level 4

1.0 Submitter

Bio-Rad Laboratories 9500 Jeronimo Road, Irvine, California 92618-2017 Telephone: (949) 598-1200 Fax: (949) 598-1555

Contact Person

Maria Zeballos Regulatory Affairs Specialist Telephone: (949) 598-1367

Date of Summary Preparation

August 11, 2003

2.0 Device Identification

Product Trade Name:Lyphochek® Coagulation Control Level 4
Common Name:Plasma Coagulation Control
Classifications:Class II
Product Code:GGN
Regulation Number:21 CFR 864.5425

3.0 Device to Which Substantial Equivalence is Claimed

Lyphochek® Coagulation Control Bio-Rad Laboratories Irvine, California

Docket Number: K012722

4.0 Description of Device

Lyphochek® Coagulation Control is prepared from human plasma, with added purified biochemicals (tissue extract from animal origin), and preservatives. The control is provided in lyophilized form for increased stability.

5.0 Statement of Intended Use

Lyphochek® Coagulation Control is intended for use as a quality control plasma to monitor the precision of citrated coagulation systems

1

6.0 Comparison of the new device with the Predicate Device

The new Lyphochek® Coagulation Control Level 4 claims substantial equivalence to the Lyphochek® Coaqulation Control currently in commercial distribution (K012722). The new Lyphochek® Coagulation Control is a tri-level (Level 1, 2 and 3) product and the current product is a single level (Level 4) product.

Bio-RadBio-Rad
CharacteristicsLyphochek® Coagulation ControlLyphochek® Coagulation Control
(Predicate Device K012722)(New Device)
Similarities
Intended UseLyphochek® Coagulation Control is intended for
use as a quality control plasma control to monitor
the precision of citrated coagulation systems.Lyphochek® Coagulation Control is intended for
use as a quality control plasma control to monitor
the precision of citrated coagulation systems.
FormLyophilizedLyophilized
MatrixHuman plasmaHuman plasma
Open Vial stability24 hours at 2 to 25°C24 hours at 2 to 25°C
Storage
(Unopened)2 to 8°C
Until expiration date2 to 8°C
Until expiration date
AnalytesProthrombin Time (PT) Activated Partial Thromboplastin Time (APTT) Fibrinogen Antithrombin II (AT III) Thrombin Time (TT)Prothrombin Time (PT) Activated Partial Thromboplastin Time (APTT) Fibrinogen Antithrombin II (AT III) Thrombin Time (TT)
Fill size1 mL1 mL
Differences
FormulationDoes not contain constituents of animal originContain constituents of animal origin
LevelsLevels 1, 2 and 3 (Does not include level 4)Level 4 (Does not include levels 1, 2 or 3)

7.0 Summary of Performance Data

Stability studies have been performed to determine the open vial stability and shelf life for the Lyphochek® Coagulation Control Level 4. Product claims are as follows:

  • 7.1 Open vial: Once the control material is reconstituted, all analytes will be stable for 24 hours when stored tightly capped at 2-25°C
  • 7.2 Shelf Life: Three years when stored at 2-8 °C
  • 7.3 Real time studies will be ongoing to support the shelf life of this product.

All supporting data is retained on file at Bio-Rad Laboratories.

2

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/2/Picture/1 description: The image shows a black and white logo. The logo consists of a circular border with text around the edge. Inside the circle is a stylized symbol that resembles three curved lines stacked on top of each other. The logo appears to be a seal or emblem.

SEP 1 7 2003

ood and Drug Administration 2098 Gaither Road Rockville MD 20850

Ms. Maria Zeballos Regulatory Affairs Specialist Bio-Rad Laboratories 9500 Jeronimo Road Irvine, California 92618-2017

Re: K032611 Trade/Device Name: Lyphochek® Coagulation Control Level 4

Regulation Number: 21 CFR § 864.5425 Regulation Name: Multipurpose System for In Vitro Coagulation Studies Regulatory Class: II Product Code: GGN Dated: August 11, 2003 Received: August 25, 2003

Dear Ms. Zeballos:

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.

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 (OS) 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.

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Page 2 -

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). You may obtain other general information on your responsibilities under the Act 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): ___________________________________________________________________________________________________________________________________________________

Lyphochek® Coagulation Control Level 4 Device Name:

Indications for Use:

Lyphochek® Coagulation Control is intended for use as a quality control plasma to monitor the precision of citrated coagulation systems.

Methods:

  • Diagnostica Stago Neoplastine C1 Plus (PT) ●
  • Diagnostica Stago PTT Automate .
  • Diagnostica Stago Fibrinogen .
  • Diagnostica Stago Stachrom (AT III) ●
  • Diagnostica Stago Thrombin .
  • Axis Shield Nycotest ●
  • Axis Shield Cephotest ●

Tugl
Division Sign-Off

Division Sign-Off

Office of In Vitro Diagnostic Device Evaluation and Safety

510(k) K092611

(PLEASE DO NOT WRITE BELOW THE LINE-CONINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription useor
----------------------

Over-the Counter use _________________________________________________________________________________________________________________________________________________________