K Number
K051074
Device Name
MAS IMMUNOSUPPRESSANT CONTROLS
Manufacturer
Date Cleared
2005-06-06

(40 days)

Product Code
Regulation Number
862.3280
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The MAS Immunosuppressant Controls, consisting of levels 1 through 3, are in-vitro diagnostic medical devices intended for use as assayed quality control material to monitor the precision of laboratory testing procedures for cyclosporine, sirolimus, and tacrolimus.
Device Description
MAS Immunosuppressant Controls is prepared from human whole blood, with pure chemicals and stabilizers. The control is provided in a liquid form containing Cyclosporine, Sirolimus, and Tacrolimus.
More Information

Not Found

No
The summary describes a quality control material for laboratory testing, not a device that processes data or images using AI/ML. The "Mentions AI, DNN, or ML" field is explicitly "Not Found".

No
The device is described as an "in-vitro diagnostic medical device intended for use as assayed quality control material to monitor the precision of laboratory testing procedures," indicating it is for diagnostic quality control, not for treating a disease or condition.

No

The device is an in-vitro diagnostic medical device intended for use as assayed quality control material to monitor the precision of laboratory testing procedures, not to diagnose a condition.

No

The device description clearly states it is a liquid control material prepared from human whole blood, indicating it is a physical substance, not software.

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

The "Intended Use / Indications for Use" section explicitly states:

"The MAS Immunosuppressant Controls, consisting of levels 1 through 3, are in-vitro diagnostic medical devices intended for use as assayed quality control material to monitor the precision of laboratory testing procedures for cyclosporine, sirolimus, and tacrolimus."

This statement directly identifies the device as an in-vitro diagnostic medical device.

N/A

Intended Use / Indications for Use

The MAS Immunosuppressant Controls, consisting of levels 1 through 3, are in-vitro diagnostic medical devices intended for use as assayed quality control material to monitor the precision of laboratory testing procedures for cyclosporine, sirolimus, and tacrolimus.

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

LAS

Device Description

MAS Immunosuppressant Controls is prepared from human whole blood, with pure chemicals and stabilizers. The control is provided in a liquid form containing Cyclosporine, Sirolimus, and Tacrolimus.

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)

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.

K022041

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

§ 862.3280 Clinical toxicology control material.

(a)
Identification. A clinical toxicology control material is a device intended to provide an estimation of the precision of a device test system and to detect and monitor systematic deviations from accuracy resulting from reagent or instrument defects. This generic type of device includes various single, and multi-analyte control materials.(b)
Classification. Class I (general 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

K051074

This summary of 510(k) safety and effectiveness information is submitted in accordance with the requirements of SMDA 1990 and 21 CFR 807.92.

510(k) Number:

Submitter:

Microgenics Corporation 46360 Fremont Blvd Fremont, CA 94538 Telephone: (510)-979-5000

Contact Person:

Lisa Charter Research and Development 46360 Fremont Blvd. Telephone: (510)-979-5142 Facsimile: (510) 979-5455

Preparation Date:

April 25, 2005

Device Information:

Device Classification Name:Drug Specific Control Materials
Common/Usual Name:Immunosuppressive Drug Control
Proprietary Name:MAS® Immunosuppressant Controls
Regulation Number:21 CFR§862.3280
Regulatory Name:Clinical toxicology control material
Product Code:LAS
Regulatory Class:Class I

Predicate Devices:

Lyphochek® Whole Blood Control (K022041) manufactured by Bio-Rad Laboratories.

Device Description:

MAS Immunosuppressant Controls is prepared from human whole blood, with pure chemicals and stabilizers. The control is provided in a liquid form containing Cyclosporine, Sirolimus, and Tacrolimus.

Intended Use:

The MAS Immunosuppressant Controls, consisting of levels 1 through 3, are in-vitro diagnostic medical devices intended for use as assayed quality control material to monitor the precision of laboratory testing procedures for cyclosporine, sirolimus, and tacrolimus.

1

Comparison to Predicate Device(s):

The Microgenics Cyclosporine Controls are substantially equivalent to Lyphochek® Whole Blood
States and Children of States Also Die Rodd Charatariae The Microgenios Oyeloopenhoed by Bio-Rad Laboratories.

DeviceSubject DevicePredicated Device
Characteristics(K022041)
Intended UseThe MAS
Immunosuppressant
Controls, consisting
of levels 1 through
3, are in-vitro
diagnostic medical
devices intended for
use as assayed
quality control
material to monitor
the precision of
laboratory testing
procedures for
cyclosporine,
sirolimus, and
tacrolimus.Lyphochek® Whole
Blood Control is
intended for use as
an assayed quality
control material to
monitor the
precision of
laboratory testing
procedures for
cyclosporine, lead,
red cell folate,
tacrolimus, and
sirolimus.
MatrixProcessed Human
Whole BloodProcessed Human
Whole Blood
FormLiquidLyophilized
AnalytesCyclosporine,
Sirolimus,
TacrolimusCyclosporine,
Lead, Red Cell
Folate, Tacrolimus,
Sirolimus
LevelsThree (3) LevelsThree (3) Levels
Open Vial
Claim14 days at 2°C to
8°C14 days at 2°C to
8°C. Exception:
Red cell folate is
stable for 3 days at
2°C to 8°C
Storage-20°C until
expiration date2°C to 8°C until
expiration date
StabilityUntil expiration date
noted on vial label.Until expiration
date noted on vial
label.

2

Summary:

The information provided in this pre-market notification demonstrates that the MAS Immunosuppressant Controls are substantially equivalent to the previously cleared predicate devices. Substantial equivalence was demonstrated through comparison of intended use and physical properties to commercially available devices. The information supplied in this premarket notification provides reasonable assurance the MAS Immunosuppressant Controls are safe and effective for the stated intended use.

MAS® is a registered trademark of Medical Analysis Systems, Inc.

3

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/3/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-like figure 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-like figure.

Food and Drug Administration 2098 Gaither Road Rockville MD 20850

JUN 6 - 2005

Ms. Lisa Charter Research and Development Microgenics Corporation 46360 Fremont Blvd Fremont, CA 94538

K051074 Re: Trade/Device Name: MAS Immunosuppressant Controls Regulation Number: 21 CFR 862.3280 Regulation Name: Clinical toxicology control material Regulatory Class: Class I Product Code: LAS Dated: April 25, 2005 Received: April 29, 2005

Dear Ms. Charter:

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).

4

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,

Carol C. Benem

Carol C. Benson, M.A. Acting Director Division of Chemistry and Toxicology Office of In Vitro Diagnostic Device Evaluation and Safety Center for Devices and Radiological Health

Enclosure

5

Indications for Use

510(k) Number (if known): Kos S 10 7 4

Device Name: MAS Immunosuppressant Controls

Indications For Use:

The MAS Immunosuppressant Controls, consisting of levels 1 through 3, are in-vitro The MAG inimal our less intended for use as assayed quality control material to ulughoutio modifical us no folaboratory testing procedures for cyclosporine, sirolimus, and tacrolimus.

X 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)

Q. Chalu

Division Sign-Off

Office of In Vitro Diagnostic Device Evaluation and Safety

510(k) K051074

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