K Number
K040987
Device Name
CRYOCHECK CLOT C
Date Cleared
2004-06-18

(64 days)

Product Code
Regulation Number
864.7290
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
CryoCheck Clot C is a clot-based assay intended for the quantitative determination of protein C activity in citrated human plasma.
Device Description
CryoCheck Clot C consists of: Protein C Deficient Plasma - contains citrated pooled normal human plasma that has been depleted of protein C by immunoadsorption. Clot C Activator - Contains protein isolated from the venom of Agkistrodon contortrix capable of activating protein C in human plasma, Russell's viper venom, phospholipids, heparin neutralizing agents, buffers and stabilizers. CS Diluent (provided separately by Precision BioLogic).
More Information

Not Found

No
The summary describes a laboratory assay kit for measuring protein C activity, which is a chemical/biological test and does not involve AI/ML. The "Mentions AI, DNN, or ML" section explicitly states "Not Found".

No
The device is an in vitro diagnostic (IVD) assay used to determine protein C activity in human plasma, which is for diagnostic purposes, not for treating or preventing disease.

Yes

The device is a clot-based assay intended for the quantitative determination of protein C activity in human plasma, which provides information for diagnosing conditions related to protein C deficiency or abnormalities.

No

The device description clearly outlines physical components (Protein C Deficient Plasma, Clot C Activator, CS Diluent) which are reagents used in a laboratory assay, not software.

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

Here's why:

  • Intended Use: The intended use explicitly states it's a "clot-based assay intended for the quantitative determination of protein C activity in citrated human plasma." This involves testing a sample taken from the human body (plasma) in vitro (outside the body) to provide information about a physiological state (protein C activity).
  • Device Description: The components described are reagents used to perform a laboratory test on a biological sample.
  • Performance Studies: The performance study compares the device to another IVD (STA - Staclot Protein C) using clinical samples, which is typical for validating an IVD.
  • Predicate Device: The mention of a predicate device (K861079; STA - Staclot Protein C) further confirms its classification as a medical device, and specifically an IVD given the context.

All these elements align with the definition of an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

CryoCheck Clot C is a clot-based assay intended for the quantitative determination of protein C activity in citrated human plasma.

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

GGP

Device Description

CryoCheck Clot C consists of: Protein C Deficient Plasma - contains citrated pooled normal human plasma that has been depleted of protein C by immunoadsorption. Clot C Activator - Contains protein isolated from the venom of Agkistrodon contortrix capable of activating protein C in human plasma, Russell's viper venom, phospholipids, heparin neutralizing agents, buffers and stabilizers. CS Diluent (provided separately by Precision BioLogic).

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)

CryoCheck Clot C was compared to STA - Staclot Protein C using 119 clinical samples from the target population for the assay. A correlation of R = 0.9142 was obtained.

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

Not Found

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.

K861079

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

§ 864.7290 Factor deficiency test.

(a)
Identification. A factor deficiency test is a device used to diagnose specific coagulation defects, to monitor certain types of therapy, to detect coagulation inhibitors, and to detect a carrier state (a person carrying both a recessive gene for a coagulation factor deficiency such as hemophilia and the corresponding normal gene).(b)
Classification. Class II (performance standards).

0

SECTION 6

510(K) Summary CryoCheck Clot C

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: _______________________________________________________________________________________________________________________________________________

| Submitters Name & Address: | Precision BioLogic Inc.
900 Windmill Road, Suite 100
Dartmouth, Nova Scotia B3B 1P7
Canada |
|-------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Contact Name: | Stephen L. Duff - Director of New Business Development
Phone: 902-468-6422 ext. 224
Fax: 902-468-6421
Email: sduff@precisionbiologic.com |
| Preparation Date: | April 13, 2004 |
| Device Name & Classification: | CryoCheck Clot CTM
Common Name: Clot-based Protein C Assay
Classification Name: Test, Qualitative and Quantitative Factor Deficiency
Regulatory Class II |
| Predicate Device: | STA - Staclot Protein C (K861079)
Diagnostica Stago
9, rue des Frères Chausson
92600 ASNIERES-SUR-SEINE (France) |
| Device Description: | CryoCheck Clot C consists of:
Protein C Deficient Plasma - contains citrated pooled normal human plasma that has been depleted of protein C by immunoadsorption. Clot C Activator - Contains protein isolated from the venom of Agkistrodon contortrix capable of activating protein C in human plasma, Russell's viper venom, phospholipids, heparin neutralizing agents, buffers and stabilizers. CS Diluent (provided separately by Precision BioLogic). |
| Device Intended Use: | CryoCheck Clot C is a clot-based assay intended for the quantitative determination of protein C activity in citrated human plasma. |

1

Comparison to Predicate Device:

ParameterCryoCheck Clot CSTA - Staclot Protein C (K861079)
Intended UseCryoCheck Clot C is a clot-based assay
intended for use in the quantitative
determination of protein C activity in
citrated human plasma.The STA - Staclot Protein C kit is intended for
use with analyzers of the STA brand name, fo
quantitative measurement of the functional
protein C level based on the prolongation of
the activated partial thromboplastin time
(APTT).
FormatFrozenLyophilized
Volume• 5 x 3.0 mL Protein C Deficient Plasma
• 5 x 3.0 mL Clot C Activator
OR
• 5 x 1.0 mL Protein C Deficient Plasma
• 5 x 1.0 mL Clot C Activator• 3 x 1mL vials of Reagent 1
(Protein C Deficient Plasma)
• 3 x 1mL vials of Reagent 2
(PC-Activator).

Correlation with Predicate Device:

CryoCheck Clot C was compared to STA - Staclot Protein C using 119 clinical samples from the target population for the assay. A correlation of R = 0.9142 was obtained.

Comments on Substantial Equivalence:

It is the opinion of Precision BioLogic Inc. that CryoCheck Clot C is substantially equivalent to STA - Staclot Protein C, manufactured by Diagnostica Stago (France), and currently marketed in the United States by Diagnostica Stago Inc. This opinion is based on the following:

  • Both products are clot-based assays. .
  • Both products are intended for use in the quantitative measurement of functional Protein C in . citrated human plasma.
  • Both products use an extract from the venom of Agkistrodon contortrix (Protac®) to activate Protein . C in test samples.
  • Both products provide all coagulation factors in excess by the use of protein C deficient plasma. .

Conclusion:

CryoCheck Clot C is substantially equivalent to STA - Staclot Protein C.

2

DEPARTMENT OF HEALTH & HUMAN SERVICES

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 or bird symbol with three curved lines representing its wings or body. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular fashion around the bird symbol. The text is in all capital letters and is evenly spaced around the circle.

Food and Drug Administration 2098 Gaither Road Rockville MD 20850

Mr. Stephen L. Duff Director of New Business Development Precision BioLogic Inc. 900 Windmill Road, Suite 100 Dartmouth, Nova Scotia Canada B3B 1P7

JUN 1 8 2004

K040987 Re: Trade/Device Name: CryoCheck Clot C Regulation Number: 21 CFR § 864.7290 Regulation Name: Factor deficiency test Regulatory Class: II

Product Code: GGP Dated: April 13, 2004 Received: April 15, 2004

Dear Mr. Duff:

We have reviewed your Section 510(k) premarket notification of intent to market the device we nave reviewed your be determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate for use stated in the encreations of the enactment date of the Medical Device Amendments, or to conninered pror to that 2011 2011 31 de rices mat have been require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The r ou may, ateres, since of the Act include requirements for annual registration, listing of general volta on anufacturing practice, labeling, and prohibitions against misbranding and adultcration.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it It your device 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 r reaso oe acrised a determination that your device complies with other requirements of the Act that I Dr Has intatutes and regulations administered by other Federal agencies. You must or any I 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 Of it Part 807), accember (QS) regulation (21 CFR Part 820). This letter requirences as beegin marketing your device as described in your Section 510(k) premarket motification. The FDA finding of substantial equivalence of your device to a legally marketed nonticate device results in a classification for your device and thus, permits your device to proceed to the market.

3

Page 2

If you desire specific information about the application of labeling requirements to your device, of In If you desire specific information access the appear device, please contact the Office of In of questions on the promotion and Safety at (301) 594-3084. Also, please note the VITO Dagnostic Dorto Development by reference to premarket notification" (21CFR Part 807.97). regulation entitled, "Misoranaming of Pricen on your responsibilities under the Act from the You may online 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,

Robert L. Becker Jr.

Robert L. Becker, Jr., M.D., Ph. Director Division of Immunology and Hematology Devices Office of In Vitro Diagnostic Device Evaluation and Safety Center for Devices and Radiological Health

Enclosure

4

Indications for Use

510(k) Number (if known): K040987

Device Name: CryoCheck Clot C

Indications For Use:

CryoCheck Clot C is a clot-based assay intended for the quantitative determination of protein C activity in citrated human plasma.

Prescription Use_V (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, Qffice of In Yitro Diagnostic Devices (OIVD)

Stephine Bautter
Division Sign-Off

Division Sign/Off

Office of In Vitro Diagnostic Device Evaluation and Safety

Page 1 of

10(k) K 04098