K Number
K042094
Device Name
R&D CBC-XE HEMATOLOGY CONTROL
Date Cleared
2004-09-01

(29 days)

Product Code
Regulation Number
864.8625
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
R&D CBC-XE Hematology Control is a tri-level control designed for use in monitoring the accuracy and precision of Sysmex™ hematology instruments. Refer to assay sheet for specific instrument models.
Device Description
This control is a hematology control mixture designed to monitor values obtained from Sysmex hematology instruments.
More Information

Not Found

No
The document describes a hematology control substance used to monitor the performance of hematology instruments. There is no mention of any software, algorithms, or data processing that would suggest the use of AI or ML. The performance studies focus on the stability and precision of the control substance itself.

No.
This device is a control used for monitoring the accuracy and precision of hematology instruments, not for treating any medical condition.

No
The device is described as a "control" designed for use in "monitoring the accuracy and precision of Sysmex™ hematology instruments." It does not directly diagnose a patient's condition.

No

The device is a hematology control mixture, which is a physical substance used for calibration and quality control of laboratory instruments, not a software application.

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

Here's why:

  • Intended Use: The intended use clearly states it's a "tri-level control designed for use in monitoring the accuracy and precision of Sysmex™ hematology instruments." This indicates it's used in vitro (outside the body) to assess the performance of a diagnostic device (the hematology instrument).
  • Device Description: It's described as a "hematology control mixture designed to monitor values obtained from Sysmex hematology instruments." This further reinforces its role in the diagnostic process by providing a known standard to check the instrument's measurements.
  • Performance Studies: The description of performance studies mentions "laboratory testing" and "remaining within the assay range," which are typical activities for evaluating the performance of an IVD control.
  • Predicate Device: The mention of a predicate device (K913879 R&D Systems CBC-8K Hematology Control) is common for IVDs seeking regulatory clearance, as it demonstrates substantial equivalence to an already approved device.

In summary, the device is used in vitro to monitor the performance of a diagnostic instrument, which is a core characteristic of an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

R&D CBC-XE Hematology Control is a tri-level control designed for use in monitoring the accuracy and precision of Sysmex™ hematology instruments. Refer to the assay sheet for specific instrument models.

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

JPK

Device Description

This control is a hematology control mixture designed to monitor values obtained from Sysmex hematology instruments.

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

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Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

Laboratory testing of 3 validation lots has shown R&D CBC-XE Hematology Control to have substantial equavalence in performance, precision and stability to the predicate device. R&D CBC-XE Hematology Control passed the acceptance criteria of remaining within the assay range over the life of the product. R&D CBC-XE Hematology Control has demonstrated precision as indicated by the small standard deviation and % CV's obtained during laboratory testing. Expiriation dating has been established at 75 days (closed vial) and 14 days, or 14 samplings (open vial) when stored at 2 - 8° C and handled according to instructons for use.

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.

K913879

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

§ 864.8625 Hematology quality control mixture.

(a)
Identification. A hematology quality control mixture is a device used to ascertain the accuracy and precision of manual, semiautomated, and automated determinations of cell parameters such as white cell count (WBC), red cell count (RBC), platelet count (PLT), hemoglobin, hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC).(b)
Classification. Class II (special controls). Except when intended for use in blood components, the device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 864.9.

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K042094

510(k) Summary R&D Systems, Inc. CBC-XE Hematology Control

Date of Summary:July 30, 2004
Company Name:R&D Systems, Inc.
614 McKinley Place N.E.
Minneapolis, MN 55413
Contact name:Ralph E. Hogancamp
612-656-4413, FAX 612-379-6809
Classification name:Hematology Quality Control Mixture
Product name:R&D CBC-XE Hematology Control
CFR section:864.8625 Hematology quality control
mixture.
Device Class:Class II

Predicate Device: R&D Systems CBC-8K Hematology Control, K913879 manufactured by R&D Systems, Inc. 614 McKinley Place N.F., Minneapolis, MN 55413

Description: This control is a hematology control mixture designed to monitor values obtained from Sysmex hematology instruments.

Intended use: R&D CBC-XF Hematology Control is a tri-level control designed for use in monitoring the accuracy and precision of Sysmex™ hematology instruments. Refer to the assay sheet for specific instrument models.

Comparison: Both products are used to monitor Sysmex™ hematology instruments. The R&D CBC-XE added new parameters.

Discussion: Laboratory testing of 3 validation lots has shown R&D CBC-XE Hematology Control to have substantial equavalence in performance, precision and stability to the predicate device. R&D CBC-XE Hematology Control passed the acceptance criteria of remaining within the assay range over the life of the product. R&D CBC-XE Hematology Control has demonstrated precision as indicated by the small standard deviation and % CV's obtained during laboratory testing. Expiriation dating has been established at 75 days (closed vial) and 14 days, or 14 samplings (open vial) when stored at 2 - 8° C and handled according to instructons for use.

Conclusion: R&D CBC-XE Hematology Control is a safe and effective control for the above intended use when used as instructed in the package insert.

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Image /page/1/Picture/1 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo consists of a stylized eagle with three lines forming its body and wings. The eagle is facing right. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular pattern around the eagle.

Food and Drug Administration 2098 Gaither Road Rockville MD 20850

Mr. Ralph E. Hogancamp Quality Assurance and Regulatory Affairs Specialist R & D Systems, Inc. 614 McKinley Place, N.E. Minneapolis, Minnesota 55413

K042094 Re:

Trade/Device Name: R & D CBC-XE Hematology Control Regulation Number: 21 CFR § 864.8625 Regulation Name: Hematology Quality Control Mixture Regulatory Class: II Product Code: JPK Dated: July 20, 2004 Received: August 5, 2004

Dear Mr. Hogancamp:

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 rcclassified 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.

SEP - 1 2004

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 Eederal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has madc 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). This letter will allow you to begin marketing your device as described in your Section 510(k) premarket notification. The FDA finding of substantial cquivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to procced to the market.

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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,

Robert L. Becker Jr.

Robert L. Becker, Jr., M.D., Ph.D. Director Division of Immunology and Hematology Devices 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): K042094

Device Name: R&D CBC-XE Hematology Control

Indications for Use:

R&D CBC-XE Hematology Control is a tri-level control designed for use in monitoring the accuracy and precision of Sysmex™ hematology instruments. Refer to assay sheet for specific instrument models.

AND/OR Prescription Use X (Part 21 CFR 801 Subpart D)

Over-The-Counter Use (21 CFR 801 Subpart C)

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

Josephine Bautista

Division Sign-Off

os of In Vitro Diagnostic Device ﺎ ﺳﺎﺗ Instantion and Seiny

510(k) K042094

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