K Number
K041750
Device Name
PTS PANELS CHOL+GLU TEST PANEL
Date Cleared
2004-07-23

(24 days)

Product Code
Regulation Number
862.1345
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Chol+Glu Test Panel is intended to measure cholesterol and glucose in whole blood on a BioScanner Plus (CardioChek brand) analyzer. The test strips are intended to be used by healthcare professionals and individuals at home to measure blood cholesterol and glucose. Cholesterol measurements are used in the diagnosis and treatment of disorders involving excess cholesterol in the blood and lipid and lipoprotein metabolism disorders. Glucose measurements are used in the management of carbohydrate metabolism disorders.
Device Description
The Chol+Glu Test Panel is a dry phase test strip that is constructed from a plastic ship holder that holds chemically heated membranes. When whole blood is placed on the test ship, the membranes first separate and isolate the red blood cells, allowing the serum/plasma to flow to the reaction membrane and react to produce a color change. The Chol+Glu Test Panel is for in vitro diagnostic use with a CardioChek brand (BioScanner Plus) reflectance photometer.
More Information

Not Found

No
The description focuses on chemical reactions and reflectance photometry, with no mention of AI/ML terms or processes.

No.
The device is an in vitro diagnostic test panel used to measure cholesterol and glucose, which aids in the diagnosis and management of conditions, rather than directly treating them.

Yes

Explanation: The "Intended Use / Indications for Use" section explicitly states, "Cholesterol measurements are used in the diagnosis and treatment of disorders involving excess cholesterol in the blood and lipid and lipoprotein metabolism disorders." This indicates that the device aids in diagnosis.

No

The device description clearly states it is a "dry phase test strip" constructed from a "plastic ship holder" and "chemically heated membranes," indicating it is a physical, hardware-based device.

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

Here's why:

  • Intended Use: The "Intended Use / Indications for Use" section explicitly states that the test panel is intended to "measure cholesterol and glucose in whole blood" and that these measurements are used in the "diagnosis and treatment of disorders" and "management of carbohydrate metabolism disorders." This clearly indicates a diagnostic purpose.
  • Device Description: The "Device Description" states that the test panel is "for in vitro diagnostic use with a CardioChek brand (BioScanner Plus) reflectance photometer." The term "in vitro diagnostic use" is a direct indicator of an IVD.
  • Mechanism: The description of how the test strip works (separating blood components and reacting to produce a color change) is consistent with the principles of in vitro diagnostic testing.

The document consistently uses language and describes a function that aligns with the definition of an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The Chol+Glu Test Panel is intended to measure cholesterol and glucose in whole blood on a CardioChek brand analyzer. The test strips are intended to be used by healthcare professionals to measure blood cholesterol and glucose. Cholesterol measurements are used in the diagnosis and treatment of disorders involving excess cholesterol in the blood and lipid and lipoprotein metabolism disorders. Glucose measurements are used in the diagnosis and treatment of carbohydrate metabolism disorders including diabetes mellitus, neonatal hypoglycemia, and idiopathic hypoglycemia and of pancreatic islet cell carcinoma.

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

NBW, CGA, CHH

Device Description

The Chol+Glu Test Panel is a dry phase test strip that is constructed from a plastic ship holder that holds chemically heated membranes. When whole blood is placed on the test ship, the membranes first separate and isolate the red blood cells, allowing the serum/plasma to flow to the reaction membrane and react to produce a color change. The Chol+Glu Test Panel is for in vitro diagnostic use with a CardioChek brand (BioScanner Plus) reflectance photometer.

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

healthcare professionals

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)

Not Found

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.

K972669, K981493, K013068

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

§ 862.1345 Glucose test system.

(a)
Identification. A glucose test system is a device intended to measure glucose quantitatively in blood and other body fluids. Glucose measurements are used in the diagnosis and treatment of carbohydrate metabolism disorders including diabetes mellitus, neonatal hypoglycemia, and idiopathic hypoglycemia, and of pancreatic islet cell carcinoma.(b)
Classification. Class II (special controls). The device, when it is solely intended for use as a drink to test glucose tolerance, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 862.9.

0

Image /page/0/Picture/1 description: The image is a black and white logo for the U.S. Department of Health & Human Services. The logo features a stylized eagle with three heads, representing the department's mission to protect the health of all Americans and provide essential human services. The eagle is encircled by the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA". The logo is simple and recognizable, conveying the department's authority and purpose.

APR 4 - 2005

Food and Drug Administration 2098 Gaither Road Rockville MD 20850

Ms. Margo Enright Manager of Clinical Affairs Polymer Technology Systems, Inc. 7736 Zionsville Road Indianapolis, IN 46268

K041750 Re: Trade/Device Name: Cho+Glu Test Panel Regulation Number: 21 CFR 862.1345 Regulation Name: Glucose test system Regulatory Class: Class II Product Code: NBW, CGA, CHH Dated: March 23,2005 Received: March 28,2005

Dear Ms. Enright:

This letter corrects our substantially equivalent letter of June 25, 2004 regarding the indications for is for your device. These types of devices are cleared for management of carbohydrate metabolism disorder and not for diagnosis of such disorders.

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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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 (240)276-0484. 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/industry/support/index.html

Sincerely yours,

Jean M. Cooper MS, DUM

Jean 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): K041750

Device Name: Chol+Glu Test Panel

Indications For Use:

The Chol+Glu Test Panel is intended to measure cholesterol and glucose in whole blood on a BioScanner Plus (CardioChek brand) analyzer. The test strips are intended to be used by healthcare professionals and individuals at home to measure blood cholesterol and glucose. Cholesterol measurements are used in the diagnosis and treatment of disorders involving excess cholesterol in the blood and lipid and lipoprotein metabolism disorders. Glucose measurements are used in the management of carbohydrate metabolism disorders.

Prescription Use_ × (Part 21 CFR 801 Subpart D) ANDVOR

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)

Page 1 of _ 1

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K041750

JUL 2 3 2004

SECTION F: 510(k) Summary

510(k) SUMMARY

This summary of safety and effectiveness information is submitted in compliance with 21CFR807.92.

1. Application Date:

June 25.2004

Applicant Information: 2.

Polymer Technology Systems, Inc 7736 Zionsville Road Indianapolis, IN 46268 Contact Person: Margo Enright Phone Number: 317-870-5610 FAX Number: 317-870-5608 e-mail: menright@PTSpanels.com

3. Trade Names:

PTS PANELS Chol+Glu Test Panel

4. Description:

The Chol+Glu Test Panel is a dry phase test strip that is constructed from a plastic ship holder that holds chemically heated membranes. When whole blood is placed on the test ship, the membranes first separate and isolate the red blood cells, allowing the serum/plasma to flow to the reaction membrane and react to produce a color change. The Chol+Glu Test Panel is for in vitro diagnostic use with a CardioChek brand (BioScanner Plus) reflectance photometer.

5. Classification Names:

Cholesterol test system Glucose test system Panel: Clinical Chemistry 75 Product Codes: CHH, CGA

    1. Facility Address:
      7736 Zionsville Road Indianapolis, IN 46268

7. Device Classification:

Class I (Regulations: 21 CFR 862.1345 and 862.1175)

Intended Use: 8.

The Chol+Glu Test Panel is intended to measure cholesterol and glucose in whole blood on a CardioChek brand analyzer. The test strips are intended to he used by healthcare professionals to measure blood cholesterol and glucose. Cholesterol measurements are used in the diagnosis and treatment of disorders involving excess cholesterol in the blood and lipid and lipoprotein metabolism disorders. Glucose measurements are used in the diagnosis and treatment of carbohydrate metabolism disorders including diabetes mellitus, neonatal hypoglycemia, and idiopathic hypoglycemia and of pancreatic islet cell carcinoma.

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    1. Reason for 510(k): Device Modification
  • Predicate Device Information 10.

The predicate devices for determination of substantial equivalence are: Name: BioScanner (PTS PANELS) Cholesterol and Glucose Test Strips Device Company: Polymer Technology Systems, Inc. 510(k) Numbers: K972669, K981493, K013068

Similarities and Differences between Chol+Glu Test Panel and the Predicate Devices:

ItemPredicatesModified Device
Intended UseIntended to measure glucose
and cholesterol in whole
blood.Same
TechnologyDry chemistry test strip for
use with PTS reflectance
photometer.Same
Measuring
RangesCholesterol: 100-400 mg/dL
Glucose: 20-600 mg/dL
Product
StorageStore in cool dry place at
room temperature of 68-86°F.Same
SpecimenWhole blood from fingerstick
or venous blood collected in
EDTA or heparin tube.Same
Chemistry
MethodsGlucose oxidase method for
glucose and enzymatic
(cholesterol esterase /
oxidase) trinder method for
cholesterol.Same
Calibration
CurveResides on a read-only
memory (EEPROM) chip
packaged with the test strips.Same

Similarities Between Predicate and Modified Device

Differences Between Predicate and Modified Pevice

ItemPredicatesModified Device
Number of
analytes per
test strip.One test per strip. Separate
cholesterol single test strip
and separate glucose test
strip.Modified device
combines
cholesterol and
glucose into single
test strip.