K Number
K053426
Date Cleared
2006-02-07

(61 days)

Product Code
Regulation Number
866.5870
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

Immunoassay for the in vitro quantitative determination of antibodies to thyroglobulin in human serum and plasma. The anti-Tg determination is used as an aid in the detection of autoimmune thyroid diseases. The electrochemiluminescence Immunoassay “ECLIA” is intended for use on the Roche Elecsys 1010/2010 and MODULAR ANALYTICS E170 (Elecsys module) immunoassay analyzers.

Device Description

The Elecsys Anti-Tg Assay is a two step sandwich immunoassay with streptavidin microparticles and electrochemiluminescence detection. Results are determined using a calibration curve that is generated specifically on each instrument by a 2-point calibration and a master curve provided with the reagent bar code.

AI/ML Overview

I am unable to provide a response as the provided text pertains to a 510(k) summary for an in vitro diagnostic device (immunoassay for thyroglobulin antibodies) and does not contain the information required to populate a table of acceptance criteria, device performance, sample sizes, expert qualifications, adjudication methods, or results of comparative effectiveness studies normally associated with AI/ML-driven medical devices. The document describes device comparison to a predicate, changes in calibrator and reagent formulations, and stability data, but not performance metrics such as sensitivity, specificity, or AUC against a ground truth dataset.

{0}------------------------------------------------

K053426

FEB 7 2006

510(k) Summary - Elecsys Anti-Tg

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 Roche Diagnostics Submitter name, address, 9115 Hague Rd contact Indianapolis IN 46250 (317) 521-3532 Contact person: Randy Johnson Date prepared: December 7, 2005 Device name Proprietary name: Roche Diagnostics Elecsys Anti-Tg Common name: Anti-Thyroid Antibodies Classification name: Thyroid Autoantibody Immunological Test System Device The Elecsys Anti-Tg Assay is a two step sandwich immunoassay with description streptavidin microparticles and electrochemiluminescence detection. Results are determined using a calibration curve that is generated specifically on each instrument by a 2-point calibration and a master curve provided with the reagent bar code. ANNE AND AND AND AND AND AND AND AND AND AND AND AND AND AND AND AND AND AND A Continued on next page

{1}------------------------------------------------

Intended useImmunoassay for the in vitro quantitative determination of antibodies to thyroglobulin in human serum and plasma. The anti-Tg determination is used as an aid in the detection of autoimmune thyroid diseases. The electrochemiluminescence Immunoassay “ECLIA” is intended for use on the Roche Elecsys 1010/2010 and MODULAR ANALYTICS E170 (Elecsys module) immunoassay analyzers.
Predicate deviceThe Elecsys Anti-Tg is equivalent to other devices legally marketed in the United States. We claim equivalence to the Elecsys Anti-Tg (K020672).

Continued on next page

{2}------------------------------------------------

Device comparison The table below compares the Elecsys Anti-Tg (K020672) and the Elecsys Anti-Tg (modified device).

TopicElecsys Anti-Tg(K020672)Elecsys Anti-Tg(Modified Device)
Intended useImmunoassay for the in vitroquantitative determination ofantibodies to thyroglobulin in humanserum and plasma. The anti-Tgdetermination is used as an aid in thedetection of autoimmune thyroiddiseases. TheelectrochemiluminescenceImmunoassay "ECLIA" is intendedfor use on the Roche Elecsys1010/2010 and MODULARANALYTICS E170 (Elecsys module)immunoassay analyzers.Same
Sample typeHuman serumHuman plasma treated with sodiumheparin, or K2/K3-EDTASame
Assay ProtocolCompetitive assaySame
DetectionProtocolElectrochemiluminescenceimmunoassaySame
TraceabilityCalibrated against NIBSC 65/93StandardSame

Continued on next page

{3}------------------------------------------------

Device comparison, continued

The table below compares the Elecsys Anti-Tg (K020672) and the Elecsys Anti-Tg (modified device).

and the comments of the comments of the comments of the comments of the comments of the comments of the comments of the comments of the comments of the comments of the commen

TopicElecsys Anti-Tg(K020672)CALIBRATORSElecsys Anti-Tg(Modified Device)
MatrixHuman serum matrixOrigin of Anti-Tg antibodies:Cal1: HumanCal2: Human (Note: Human wasincorrectly listed in the package insertupon submission. Cal2 was of sheeporigin at the time of the submission.)SameOrigin of Anti-Tg antibodies:Call: SameCal2: Sheep (Note: Correction of theerror in the package insert from theK020672 filing)
Storage formCalibrator: LiquidCalibrator: Lyophilized
Target valuesCal 1: 40 IU/mLCal 2: 3,250 IU/mLSame
StabilityUnopened at 2 - 8°C:Up to the stated expiration dateAfter opening:8 weeks at 2 - 8°COn Elecsys 1010/2010 analyzer:Up to 5 hours at 20 - 25°COn E170: Use once onlyLyophilized:Up to the stated expiration dateReconstituted:6 weeks at 2 - 8°COn Elecsys 1010/2010 at 20 - 25°C:Up to 5 hoursOn MODULAR ANALYTICS E170:Use only once
Filling volume1.3 mL1.5 mL
TopicElecsys Anti-Tg (K020672)Elecsys Anti-Tg (Modified Device)
REAGENTS
StabilityUnopened at 2 - 8°C:Up to the stated expiration dateAfter opening:12 weeks at 2 - 8°COn E170/Elecsys 2010: 6 weeksOn Elecysys 1010: 6 weeks (storedalternately in the refrigerator and onthe analyzer - ambient temperature 20- 25°C; up to 20 hours opened in total)Unopened at 2 - 8°C:Up to the stated expiration dateAfter opening at 2 - 8°C:6 weeks (Harmonized to calibratorstability claim)On MODULAR ANALYTICS E170:6 weeksOn Elecsys 2010: 6 weeksOn Elecsys 1010: 6 weeks (storedalternately in the refrigerator and onthe analyzer - ambient temperature 20- 25°C; up to 20 hours opened in total)
Reagent 2 (R2)Monoclonal anti-Tg antibodies(human) labeled with rutheniumcomplex 0.520 mg/LMonoclonal anti-Tg antibodies(human) labeled with rutheniumcomplex 0.620 mg/L
CONTROLS
StabilityUnopened at 2 - 8°C:Up to the stated expiration datePC A-Tg1, PC A -Tg2, after opening:8 weeks at 2 - 8°COn Elecsys 1010/2010 analyzers: upto 5 hour at 20 - 25°COn E170: use once onlyUnopened at 2 - 8°C:Up to the stated expiration datePC A-TG1, PC A-TG2, after opening:6 weeks at 2 - 8°C (Harmonized tocalibrator stability claim)On Elecsys 1010/2010 at 20 - 25°C:Up to 5 hoursOn MODULAR ANALYTICS E170:Use only once

Continued on next page

{4}------------------------------------------------

Device comparison, continued

ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ

The table below compares the Elecsys Anti-Tg (K020672) and the Elecsys Anti-Tg (modified device).

のお得ないので、その他のお気になる。

{5}------------------------------------------------

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/5/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features a stylized eagle with three tail feathers. The eagle is facing to the right. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circle around the eagle.

Public Health Service

Food and Drug Administration 2098 Gaither Road Rockville MD 20850

FEB 7 2006

Roche Diagnostics Corp. c/o Randy J. Johnson MT (ASCP) Regulatory Affairs Consultant 9115 Hague Rd. Indianapolis, IN 46250

Re: K053426

Trade/Device Name: Roche Diagnostics Elecsys Anti-Tg Regulation Number: 21 CFR 866.5870 Regulation Name: Thyroid autoantibody immunological test system Regulatory Class: Class II Product Code: JZO Dated: December 7, 2005 Received: December 8, 2005

Dear Mr. Johnson:

We have reviewed your Section 510(k) premarket notification of intent to market the device we nave reviewed your bection 910(t) production is substantially equivalent (for the indications for referenced above and have acterially marketed predicate devices marketed in interstate commerce use stated in the eneround to regard date of the Medical Device Amendments, or to devices that prior to May 26, 1770, inc onceentine ask the provisions of the Federal Food, Drug, and Cosmetic liave been receasined in are approval of a premarket approval application (PMA). You may, ACC (ACC) that ao not require apple for the general controls provisions of the Act. The general therefore, market the detrice, sacfoot, we animents for annual registration, listing of devices, good controls provisions of misters, and prohibitions against misbranding and adulteration.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it If your device to such additional controls. Existing major regulations affecting your device can be Illay be subject to such additions. Title 21, Parts 800 to 898. 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 lease be advised that I Dri 3 isounted on a sodenies complies with other requirements of the Act or that FDA has made a dolornination 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); an the Act 3 requirements, morading, practice requirements as set forth in the quality labeling (21 CFR Part 800); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

{6}------------------------------------------------

Page 2 -

This letter will allow you to begin marketing your device as described in your Section 510(k) I his letter will anow you to begin mailteing of substantial equivalence of your device to a legally premarket notification: "The PDF mailing of Cation for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please If you desire specific advice for your don't to may be as note the regulation entitled, comact the Other of Comphance as (210) for Part 807.97). You may obtain other IMISoraniumig of reference to promaibilities under the Act from the Division of Small general information on your responsionner Assistance at its toll-free number (800) 638-2041 or Manufacturers, International and Consultive views.fda.gov/cdrh/industry/support/index.html.

Sincercly yours,

Robert H. 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

{7}------------------------------------------------

Indications for Use

510(k) Number (if known):

K053426

Device Name: Elecsys Anti-Tg

Indications For Use:

Immunoassay for the in vitro quantitative determination of antibodies to thyroglobulin in human serum and plasma. The anti-Tg determination is used as an aid in the detection of autoimmune thyroid diseases. The electrochemiluminescence Immunoassay "ECLIA" is intended for use on the Roche Elecsys 1010/2010 and MODULAR ANALYTICS E170 (Elecsys module) immunoassay analyzers.

Prescription Use XXXX (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)

Mana Chan
Division Sign-Off

Office ef this in Diagnostic Device Evaluation mot houry

Confidential

510(k)_ 405 3426

23

§ 866.5870 Thyroid autoantibody immunological test system.

(a)
Identification. A thyroid autoantibody immunological test system is a device that consists of the reagents used to measure by immunochemical techniques the thyroid autoantibodies (antibodies produced against the body's own tissues). Measurement of thyroid autoantibodies may aid in the diagnosis of certain thyroid disorders, such as Hashimoto's disease (chronic lymphocytic thyroiditis), nontoxic goiter (enlargement of thyroid gland), Grave's disease (enlargement of the thyroid gland with protrusion of the eyeballs), and cancer of the thyroid.(b)
Classification. Class II (performance standards).