K Number
K040174
Device Name
BILIRUBIN ASSAY ON THE OMNI S ANALYZER
Date Cleared
2004-05-14

(109 days)

Product Code
Regulation Number
862.1113
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Roche Diagnostics OMNI S Analyzer is a fully automated critical care analyzer intended to be used for the measurement of pH, PO2, PCO2, sodium, potassium, ionized calcium, chloride, hematocrit, glucose, lactate, urca/BUN, bilirubin, total hemoglobin, oxygen saturation, oxyhemoglobin, deoxyhemoglobin, carboxyhemoglobin and methemoglobin in samples of whole blood, serum, plasma and aqueous solutions as appropriate.
Device Description
The Roche Diagnostics OMNI S Analyzer is a fully automated critical care analyzer intended to be used for the measurement of pH, PO2, PCO2, sodium, potassium, ionized calcium, chloride, hematocrit, glucose, lactate, urea/BUN, bilirubin. hemoglobin, oxygen saturation, oxyhemoglobin, total deoxyhemoglobin, carboxyhemoglobin and methemoglobin in samples of whole blood, serum, plasma and aqueous solutions as appropriate.
More Information

No
The summary describes a standard automated critical care analyzer measuring various analytes. There is no mention of AI, ML, image processing, or any other indicators of AI/ML technology.

No
The device is an analyzer for measuring various substances in biological samples, primarily for diagnostic purposes, and does not directly provide therapy.

Yes
The "Intended Use / Indications for Use" states that the device is a "fully automated critical care analyzer intended to be used for the measurement of pH, PO2, PCO2, sodium, potassium, ionized calcium, chloride, hematocrit, glucose, lactate, urca/BUN, bilirubin, total hemoglobin, oxygen saturation, oxyhemoglobin, deoxyhemoglobin, carboxyhemoglobin and methemoglobin". Measuring these bodily parameters helps in diagnosing medical conditions, which fits the definition of a diagnostic device.

No

The device description clearly states it is a "fully automated critical care analyzer," which implies significant hardware components for sample handling, analysis, and measurement of various parameters.

Yes, based on the provided information, the Roche Diagnostics OMNI S Analyzer is an IVD (In Vitro Diagnostic) device.

Here's why:

  • Intended Use: The intended use explicitly states that the device is used for the "measurement of pH, PO2, PCO2, sodium, potassium, ionized calcium, chloride, hematocrit, glucose, lactate, urca/BUN, bilirubin, total hemoglobin, oxygen saturation, oxyhemoglobin, deoxyhemoglobin, carboxyhemoglobin and methemoglobin in samples of whole blood, serum, plasma and aqueous solutions". This involves testing samples taken from the body (in vitro) to provide diagnostic information.
  • Device Description: The description reiterates the measurement of various analytes in biological samples (whole blood, serum, plasma).
  • Performance Studies: The performance studies compare the bilirubin parameter to other legally marketed analyzers, which are also typically IVD devices used for diagnostic testing.
  • Predicate Devices: The listed predicate devices (Roche Hitachi Analyzers, Radiometer ABL735, Beckman LX®20 System, Kodak Vitros System) are all well-known IVD analyzers used in clinical laboratories.

The core function of the device is to analyze biological samples outside of the body to provide information about a patient's health status, which is the definition of an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The OMNI S bilirubin claim is for the determination of neonatal bilirubin in newborns using whole blood samples.

The Roche Diagnostics OMNI S Analyzer is a fully automated critical care analyzer intended to be used for the measurement of pH, PO2, PCO2, sodium, potassium, ionized calcium, chloride, hematocrit, glucose, lactate, urca/BUN, bilirubin, total hemoglobin, oxygen saturation, oxyhemoglobin, deoxyhemoglobin, carboxyhemoglobin and methemoglobin in samples of whole blood, serum, plasma and aqueous solutions as appropriate.

Product codes

MQM

Device Description

The Roche Diagnostics OMNI S Analyzer is a fully automated critical care analyzer intended to be used for the measurement of pH, PO2, PCO2, sodium, potassium, ionized calcium, chloride, hematocrit, glucose, lactate, urea/BUN, bilirubin. hemoglobin, oxygen saturation, oxyhemoglobin, total deoxyhemoglobin, carboxyhemoglobin and methemoglobin in samples of whole blood, serum, plasma and aqueous solutions as appropriate.

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

neonatal/newborns

Intended User / Care Setting

Critical care

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

The bilirubin parameter for use on the OMNI S Analyzer was compared to several legally marketed analyzers in the method comparison studies. It was compared to the bilirubin assay on the Roche Hitachi Analyzers (K981632), the Radiometer ABL735 (K991417), the Beckman LX®20 System (K011213) and the Kodak Vitros System (K840880).

Key Metrics

Not Found

Predicate Device(s)

K991417, K981632, K011213, K840880

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 862.1113 Bilirubin (total and unbound) in the neonate test system.

(a)
Identification. A bilirubin (total and unbound) in the neonate test system is a device intended to measure the levels of bilirubin (total and unbound) in the blood (serum) of newborn infants to aid in indicating the risk of bilirubin encephalopathy (kernicterus).(b)
Classification. Class I.

0

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510(k) Summary ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------According to the requirements of 21 CFR 807.92, the following information Introduction provides sufficient detail to understand the basis for a determination of substantial equivalence. 1) Submitter Roche Diagnostics Corporation name, address, 9115 Hague Rd. contact Indianapolis, IN 46250 Contact Person: Jennifer Tribbett Date Prepared: January 23, 2004 2) Device name Proprietary name: Bilirubin Assay on the OMNI S Analyzer Common name: Bilirubin (total and unbound) in the neonate test system Classification name: Bilirubin (total and unbound) in the neonate test system ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------3) Predicate The bilirubin parameter for use on the OMNI S Analyzer is substantially device equivalent to the legally marketed bilirubin assay on the Roche Hitachi Analyzers (K981632), the Radiometer ABL735 (K991417), the Beckman LX®20 System (K011213) and the Kodak Vitros System (K840880). The Roche Diagnostics OMNI S Analyzer is a fully automated critical care 4) Device Description analyzer intended to be used for the measurement of pH, PO2, PCO2, sodium, potassium, ionized calcium, chloride, hematocrit, glucose, lactate, urea/BUN, bilirubin. hemoglobin, oxygen saturation, oxyhemoglobin, total deoxyhemoglobin, carboxyhemoglobin and methemoglobin in samples of whole blood, serum, plasma and aqueous solutions as appropriate. 5) Intended use The OMNI S bilirubin claim is for the determination of neonatal bilirubin in newborns using whole blood samples.

MAY 1 4 2004

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The bilirubin parameter for use on the OMNI S Analyzer was compared to 6) Substantial equivalence several legally marketed analyzers in the method comparison studies. It was Similarities and compared to the bilirubin assay on the Roche Hitachi Analyzers (K981632), Differences the Radiometer ABL735 (K991417), the Beckman LX®20 System (K011213) and the Kodak Vitros System (K840880).

The OMNI S bilirubin claim is for the determination of neonatal bilirubin in newborns using whole blood samples. The primary predicate device is the Radiometer ABL735, which determines neonate bilirubin using the same sample type (whole blood).

The method comparison studies also showed acceptable performance versus other analyzers, the Roche Hitachi Analyzers (K981632), the Beckman LX®20 System (K011213), and the Kodak Vitros System (K840880), which claim the determination of bilirubin in serum and plasma.

2

Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized eagle with three stripes forming its body and wings. The eagle is enclosed within a circular border, and the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged around the upper half of the circle.

Food and Drug Administration 2098 Gaither Road Rockville MD 20850

MAY 1 4 2004

Ms. Jennifer Tribbett Regulatory Affairs Principal Roche Diagnostics Corp. 9115 Hague Road Indianapolis, IN 46256

K040174 Trade/Device Name: Bilirubin Assay on the OMNI S Analyzer Regulation Number: 21 CFR 862.1113 Regulation Name: Bilirubin (total and unbound) in the neonate test system Regulatory Class: Class I Product Code: MQM Dated: April 5, 2004 Received: April 7, 2004

Dear Ms. Tribbett:

Re:

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 (QS) regulation (21 CFR Part 820).

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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). 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,

Jean M. Cooper, 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

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Indications for Use

510(k) Number (if known): K040174

Device Name: Bilirubin Assay on the OMNI S Analyzer

Indications For Use:

The Roche Diagnostics OMNI S Analyzer is a fully automated critical care analyzer intended to be used for the measurement of pH, PO2, PCO2, sodium, potassium, ionized calcium, chloride, hematocrit, glucose, lactate, urca/BUN, bilirubin, total hemoglobin, oxygen saturation, oxyhemoglobin, deoxyhemoglobin, carboxyhemoglobin and methemoglobin in samples of whole blood, serum, plasma and aqueous solutions as appropriate.

Prescription Use (Part 21 CFR 801 Subpart D)

AND/OR

Over-The-Counter Use (21 CFR 807 Subpart C)

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of In Vitro Diagnostic Devices (OIVD)

Carol Benson
Division Sign-Off

Office of In Vitro Diagno evice Evaluation and

510(k) K040174

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