K Number
K033860
Device Name
AUTOKIT TOTAL KETONE BODIES KIT (SERUM) AND WAKO KETONE BODY CALIBRATOR
Date Cleared
2004-04-23

(133 days)

Product Code
Regulation Number
862.1150
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Wako Total Ketone Body Calibrators are intended to be used with the Wako Autokit Total Ketone Body products and instruments to establish points of reference that are used in the determination of values in the measurement of total ketone bodies and 3-hydroxybutyrate in human serum or plasma.
Device Description
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More Information

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No
The document describes calibrators for a diagnostic test and does not mention any AI or ML components.

No
This device is a calibrator, used to establish reference points for measurements, not to treat a condition.

Yes
The device is described as "calibrators" used to establish "points of reference that are used in the determination of values in the measurement of total ketone bodies and 3-hydroxybutyrate in human serum or plasma," which directly supports and contributes to diagnostic testing.

No

The device is described as "Calibrators" intended for use with "products and instruments," which strongly suggests a physical component used for calibration, not a software-only device. The lack of a device description further supports this interpretation.

Yes, based on the provided information, this device is an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use clearly states that the calibrators are used "in the determination of values in the measurement of total ketone bodies and 3-hydroxybutyrate in human serum or plasma." This describes a process performed in vitro (outside the body) on human specimens (serum or plasma) to obtain diagnostic information (measurement of ketone bodies).
  • Predicate Device: The presence of a predicate device (K035600) strongly suggests that this device is regulated as a medical device, and given its intended use, it falls under the category of IVDs.

Therefore, the description aligns with the definition of an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The Wako Total Ketone Body Calibrators are intended to be used with the Wako Autokit Total The Wako Total Ketone Dodf Canadacts and inst to establish points of reference that are used in the determination of values in the measurement of total ketone bodies and 3-hydroxybutyrate in human serum or plasma.

Product codes

JIT

Device Description

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Mentions image processing

Not Found

Mentions AI, DNN, or ML

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Input Imaging Modality

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Anatomical Site

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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

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Summary of Performance Studies

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Key Metrics

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Predicate Device(s)

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Reference Device(s)

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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

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/0/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" arranged around the perimeter. Inside the circle is a stylized image of an eagle with its wings spread, representing the department's mission to protect the health of all Americans. The eagle is depicted in a simple, graphic style with flowing lines.

APR 2 3 2004

Public Health Service

Food and Drug Administration 2098 Gaither Road Rockville MD 20850

Ms. Tonya Mallory Executive Manager Wako Chemicals, USA, Inc. 1600 Bellwood Road Richmond, VA 23237

K033860 Rc:

K035600
Trade/Device Name: Wako Total Ketone Body Calibrators Regulation Number: 21 CFR 862.1150 Regulation Name: Calibrator Regulatory Class: Class II Product Code: JIT Dated: March 26, 2004 Received: March 29, 2004

Dear Ms. Mallory:

We have reviewed your Section 510(k) premarket notification of intent to market the device we have reviewed your Section 910(x) premainer's substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate for use stated in the encrosule) with the enactment date of the Medical Device American of Each Drug commerce provision of this the encordance with the provisions of the Federal Food, Drug, devices that have been reclassified in accordained while approval application (PMA). and Cosmelle Act (Act) that do not require subject to the general controls provisions of the Act. The Y ou may, utcrerore, market the act include requirements for annual registration, listing of general controls provisions of the free labeling, and prohibitions against misbranding and adulteration.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), If your device is classified (Scc above) into entist vias major regulations affecting your device it may be subject to such additional controls. Existing may of together and to 895. In addition, FDA call be lound in Title 21, Code of Pederal regions region in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean Please be advised that I Dri 3 issuated of a became of the requirements of the Act
that FDA has made a determination that your device complies with other requirements of the that IDA has made a decemination administered by other Federal agencies. You must of any Federal Statutes and regulations and mittered of rogistration and listing (21 comply with an the Act 3 requirements, morating moraling macines and good manufacturing practice CFR Part 807), labeling (21 OF R Patters (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) This letter with anow you to ocgin mailities of your device of your device to a legally prematics notification: "The Presults 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 you destre specific mixotion and advertising of your device, please contact the Office of or questions on the promotion and Safety at (301) 594-3084. Also, please note the In 7 th o Diagiostic Dorrios 24 reference to premarket notification" (21CFR Part 807.97). Togulation chinica, "Thoormation on your responsibilities under the Act from the r out may oounly buter general missional 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,

Jean M. Cooper, MS, DVM.
MS, DVM.

Yean M. Cooper, MS, D.V.M. Director Division of Chemistry and Toxicology Office of In Vitro Diagnostic Device Evaluation and Safety Center for Devices and Radiological Health

Enclosure

2

Indications for Use:

510(K) Number (if known): K033860

Wako Total Ketone Body Calibrators Device Name:

The Wako Total Ketone Body Calibrators are intended to be used with the Wako Autokit Total The Wako Total Ketone Dodf Canadacts and inst to establish points of reference that are used in the determination of values in the measurement of total ketone bodies and 3-hydroxybutyrate in human serum or plasma.

Proprietary Name: Wako Total Ketone Body Calibrators

Established Registration Number: 1627434

Premarket Notification 510 (k) Number: K033860

(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)

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Over-The-Counter Use_ (Optional Format 1-2-96)

Division Sign-Off

Office of In Vitro Dlagnostic Device Evaluation and Safety

510(k) K033860