K Number
K060444
Device Name
BD PHOENIX AUTOMATED MICROBIOLOGY SYSTEM - CEFEPIME (GN) , CEFTRIAXONE (GN), CEFOTAXIME (GN), 0.5-64 UG/ML
Date Cleared
2006-04-12

(50 days)

Product Code
Regulation Number
866.1645
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The BD Phoenix™ Automated Microbiology System is intended for the rapid identification and in vitro antimicrobial susceptibility testing of isolates from pure culture of most aerobic and facultative anaerobic Gram-negative and Gram-positive bacteria of human origin. The BD Phoenix™ Automated Microbiology System is intended for in vitro quantitative determination of antimicrobial susceptibility by minimal inhibitory concentration (MIC) of most Gram-negative aerobic and facultative anaerobic bacteria isolates from pure culture for Enterobacteriaceae and Non-Enterobacteriaceae and most Gram-positive bacteria isolates from pure culture belonging to the genera Staphylococcus, Enterococcus, and Streptococcus. This premarket notification is for additional organism groups and BD Phoenix™ Automated Microbiology System with cefepime (0.5-64 µg/mL) and ceftriaxone (0.5-64 µg/mL) on Gramnegative ID/AST or AST only Phoenix panels.
Device Description
The BD Phoenix Automated Microbiology System (Phoenix System) is an automated system for the rapid identification (ID) and antimicrobial susceptibility testing (AST) of clinically relevant bacterial isolates. The system includes the following components: - . BD Phoenix instrument and software. - BD Phoenix panels containing biochemicals for organism ID testing and antimicrobial agents . for AST determinations. - BD Phoenix ID Broth used for performing ID tests and preparing AST Broth inoculum. . - . BD Phoenix AST Broth used for performing AST tests only. - BD Phoenix AST Indicator solution added to the AST Broth to aid in bacterial growth . determination. The Phoenix AST method is a broth based microdilution test. The Phoenix System utilizes a redox indicator for the detection of organism growth in the presence of an antimicrobial agent. Measurements of changes to the indicator as well as bacterial turbidity are used in the determination of bacterial growth. Each AST panel configuration contains several antimicrobial agents with a wide range of two-fold doubling dilution concentrations. The Phoenix panel is a sealed and self-inoculating molded polystyrene tray with 136 micro-wells containing dried reagents. Organisms for susceptibility testing must be a pure culture and preliminarily identified as a Gram-negative or Gram-positive isolate. Phoenix panels are inoculated with a specified organism density and placed into the instrument. The instrument houses the panels where they are continuously incubated at a nominal temperature of 35℃. The instrument takes readings of the panels every 20 minutes. The readings are interpreted to give an identification of the isolate, minimum inhibitory concentration (MIC) values and category interpretations, S, I, or R (sensitive, intermediate, or resistant).
More Information

Not Found

No
The document describes an automated system that uses a redox indicator and turbidity measurements to determine bacterial growth and susceptibility. While automated, there is no mention of AI, ML, or related concepts in the device description, intended use, or performance studies. The interpretation of readings appears to be based on pre-defined thresholds or algorithms rather than learned patterns.

No.
The device is used for in vitro diagnostic testing (identification and antimicrobial susceptibility testing of bacterial isolates) and does not directly treat or diagnose a disease.

Yes

The device is intended for the rapid identification and antimicrobial susceptibility testing of isolates, providing "in vitro quantitative determination of antimicrobial susceptibility by minimal inhibitory concentration (MIC)" and "category interpretations, S, I, or R (sensitive, intermediate, or resistant)" which are used to aid in diagnosis and treatment decisions.

No

The device description explicitly lists hardware components such as the "BD Phoenix instrument" and "BD Phoenix panels," indicating it is not solely software.

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 system is intended for "in vitro antimicrobial susceptibility testing of isolates from pure culture of most aerobic and facultative anaerobic Gram-negative and Gram-positive bacteria of human origin." and "in vitro quantitative determination of antimicrobial susceptibility". The term "in vitro" is a key indicator of an IVD.
  • Device Description: The description details a system that analyzes biological samples (bacterial isolates from pure culture) outside of the human body to provide information about their characteristics (identification and susceptibility to antimicrobial agents). This aligns with the definition of an IVD.
  • Performance Studies: The performance studies compare the device's results to a "CLSI reference broth microdilution method," which is a standard laboratory method for in vitro testing.

The entire context of the document describes a device used in a laboratory setting to test biological samples for diagnostic purposes related to bacterial infections and their treatment.

N/A

Intended Use / Indications for Use

The BD Phoenix ™ Automated Microbiology System is intended for the rapid identification and in vitro antimicrobial susceptibility testing of isolates from pure culture of most aerobic and facultative anaerobic Gram-negative and Gram-positive bacteria of human origin.

The BD Phoenix™ Automated Microbiology System is intended for in vitro quantitative determination of antimicrobial susceptibility by minimal inhibitory concentration (MIC) of most Gram-negative aerobic and facultative anaerobic bacteria isolates from pure culture for Enterobacteriaceae and Non-Enterobacteriaceae and most Gram-positive bacteria isolates from pure culture belonging to the genera Staphylococcus, Enterococcus, and Streptococcus.

This premarket notification is for additional organism groups and BD Phoenix™ Automated Microbiology System with cefepime (0.5-64 µg/mL) and ceftriaxone (0.5-64 µg/mL) on Gramnegative ID/AST or AST only Phoenix panels.

Product codes

LON

Device Description

The BD Phoenix Automated Microbiology System (Phoenix System) is an automated system for the rapid identification (ID) and antimicrobial susceptibility testing (AST) of clinically relevant bacterial isolates. The system includes the following components:

  • . BD Phoenix instrument and software.
  • BD Phoenix panels containing biochemicals for organism ID testing and antimicrobial agents . for AST determinations.
  • BD Phoenix ID Broth used for performing ID tests and preparing AST Broth inoculum. .
  • . BD Phoenix AST Broth used for performing AST tests only.
  • BD Phoenix AST Indicator solution added to the AST Broth to aid in bacterial growth . determination.

The Phoenix AST method is a broth based microdilution test. The Phoenix System utilizes a redox indicator for the detection of organism growth in the presence of an antimicrobial agent. Measurements of changes to the indicator as well as bacterial turbidity are used in the determination of bacterial growth. Each AST panel configuration contains several antimicrobial agents with a wide range of two-fold doubling dilution concentrations.

The Phoenix panel is a sealed and self-inoculating molded polystyrene tray with 136 micro-wells containing dried reagents. Organisms for susceptibility testing must be a pure culture and preliminarily identified as a Gram-negative or Gram-positive isolate. Phoenix panels are inoculated with a specified organism density and placed into the instrument.

The instrument houses the panels where they are continuously incubated at a nominal temperature of 35℃. The instrument takes readings of the panels every 20 minutes. The readings are interpreted to give an identification of the isolate, minimum inhibitory concentration (MIC) values and category interpretations, S, I, or R (sensitive, intermediate, or resistant).

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

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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

Clinical, stock and challenge isolates were tested across multiple geographically diverse sites across the United States.
For Challenge set isolates, Phoenix System results were compared to the expected results.
For clinical isolates, Phoenix System results were compared to the results obtained from the CLSI reference broth microdilution method.

Summary of Performance Studies

Study Type: Substantial Equivalence Studies (Site Reproducibility and Clinical Studies)

Site Reproducibility:
Sample size: Multiple isolates (panel chosen isolates).
Tested in triplicate on three different days using one lot of Phoenix panels containing the antimicrobial agents and associated reagents.
Key results: For each antimicrobial agent there was an overall intra-site reproducibility of greater than 90% and an overall inter-site reproducibility greater than 95% for the isolates tested.

Clinical Studies:
Sample size:
Cefepime: 1789 isolates tested for Essential Agreement and Category Agreement.
Ceftriaxone: 1872 isolates tested for Essential Agreement and Category Agreement.
Key results:
The performance of the Phoenix System was assessed by calculating Essential Agreement (EA) and Category Agreement (CA) to expected/reference results for all isolates tested.
Essential Agreement (EA) occurs when the BD Phoenix™ Automated Microbiology System agrees exactly or within ± one two-fold dilution to the reference result. Category Agreement (CA) occurs when the BD Phoenix™ Automated Microbiology System agrees with the reference method with respect to the FDA categorical interpretive criteria (susceptible, intermediate, and resistant).

Table 1: Performance of BD Phoenix System by Drug
Cefepime (0.5-64 μg/mL): EA (n)=1789, EA (%)=95.2; CA (n)=1789, CA (%)=92.9
Ceftriaxone (0.5-64 μg/mL): EA (n)=1872, EA (%)=95.8; CA (n)=1872, CA (%)=90.9

The data collected from the substantial equivalence studies demonstrate that testing on the BD Phoenix™ Automated Microbiology System with this antimicrobial agent is substantially equivalent as outlined in the FDA draft guidance document, "Class II Special Controls Guidance Document: Antimicrobial Susceptibility Test (AST) Systems: Guidance for Industry and FDA." February 5, 2003.

Key Metrics

Essential Agreement (EA) %: 95.2% (Cefepime), 95.8% (Ceftriaxone)
Category Agreement (CA) %: 92.9% (Cefepime), 90.9% (Ceftriaxone)
Intra-site reproducibility: >90%
Inter-site reproducibility: >95%

Predicate Device(s)

VITEK® System (PMA No. N50510), K020321, K032675, K032655

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 866.1645 Fully automated short-term incubation cycle antimicrobial susceptibility system.

(a)
Identification. A fully automated short-term incubation cycle antimicrobial susceptibility system is a device that incorporates concentrations of antimicrobial agents into a system for the purpose of determining in vitro susceptibility of bacterial pathogens isolated from clinical specimens. Test results obtained from short-term (less than 16 hours) incubation are used to determine the antimicrobial agent of choice to treat bacterial diseases.(b)
Classification. Class II (special controls). The special control for this device is FDA's guidance document entitled “Class II Special Controls Guidance Document: Antimicrobial Susceptibility Test (AST) Systems; Guidance for Industry and FDA.”

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510(K) SUMMARY

| SUBMITTED BY: | Becton, Dickinson and Company
7 Loveton Circle
Sparks, MD 21152
Phone: (410) 316 - 4278
Fax: 410-316-4499 |
|------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| CONTACT NAME: | Monica E Giguere
Regulatory Affairs Specialist |
| DATE PREPARED: | March 30, 2006 |
| DEVICE TRADE NAME: | BD Phoenix ™ Automated Microbiology System --
Cefepime-0.5-64 µg/mL and Ceftriaxone-0.5-64 µg/mL, |
| DEVICE COMMON NAME: | Antimicrobial susceptibility test system-short incubation |
| DEVICE CLASSIFICATION: | Fully Automated Short-Term Incubation Cycle Antimicrobial
Susceptibility Device, 21 CFR 866.1645 |
| PREDICATE DEVICES: | VITEK ® System (PMA No. N50510) and BD Phoenix ™
Automated Microbiology System with Gatifloxacin (K020321,
May 23, 2002), Cefepime-0.5-64 µg/mL (K032675, March 1,
2004) and Ceftriaxone -0.5-64 µg/mL (K032655,
October 6, 2003) |
| INTENDED USE: | The BD Phoenix ™ Automated Microbiology System is
intended for the rapid identification and in vitro antimicrobial
susceptibility testing of isolates from pure culture of most
aerobic and facultative anaerobic Gram-negative and Gram-
positive bacteria of human origin. |

DEVICE DESCRIPTION:

The BD Phoenix Automated Microbiology System (Phoenix System) is an automated system for the rapid identification (ID) and antimicrobial susceptibility testing (AST) of clinically relevant bacterial isolates. The system includes the following components:

  • . BD Phoenix instrument and software.
  • BD Phoenix panels containing biochemicals for organism ID testing and antimicrobial agents . for AST determinations.
  • BD Phoenix ID Broth used for performing ID tests and preparing AST Broth inoculum. .
  • . BD Phoenix AST Broth used for performing AST tests only.

1

  • BD Phoenix AST Indicator solution added to the AST Broth to aid in bacterial growth . determination.
    The Phoenix AST method is a broth based microdilution test. The Phoenix System utilizes a redox indicator for the detection of organism growth in the presence of an antimicrobial agent. Measurements of changes to the indicator as well as bacterial turbidity are used in the determination of bacterial growth. Each AST panel configuration contains several antimicrobial agents with a wide range of two-fold doubling dilution concentrations.

The Phoenix panel is a sealed and self-inoculating molded polystyrene tray with 136 micro-wells containing dried reagents. Organisms for susceptibility testing must be a pure culture and preliminarily identified as a Gram-negative or Gram-positive isolate. Phoenix panels are inoculated with a specified organism density and placed into the instrument.

The instrument houses the panels where they are continuously incubated at a nominal temperature of 35℃. The instrument takes readings of the panels every 20 minutes. The readings are interpreted to give an identification of the isolate, minimum inhibitory concentration (MIC) values and category interpretations, S, I, or R (sensitive, intermediate, or resistant).

DEVICE COMPARISON:

The BD Phoenix™ Automated Microbiology System demonstrated substantially equivalent performance when compared with the CLSI reference broth microdilution method. This premarket notification provides data for additional organism groups with Cefepime - 0.5-64 ug/mL and Ceftriaxone - 0.5-64 µg/mL and the BD Phoenix™ Automated Microbiology System.

SUMMARY OF SUBSTANTIAL EQUIVALENCE TESTING:

The BD Phoenix™ Automated Microbiology System has demonstrated substantially equivalent performance when compared to the CLSI reference broth microdilution method (AST panels prepared according to NCCLS M7). The system has been evaluated as defined in the FDA Draft guidance document, "Class II Special Controls Guidance Document: Antimicrobial Susceptibility Test (AST) Systems: Guidance for Industry and FDA," February 5, 2003.

Site Reproducibility

Intra- and inter-site reproducibility of this antimicrobial agent in the BD Phoenix System was evaluated at three sites using a panel chosen isolates. Each site tested the isolates in triplicate on three different days using one lot of Phoenix panels containing the antimicrobial agents and associated reagents.

The results of the study demonstrate for each antimicrobial agent there was an overall intra-site reproducibility of greater than 90% and an overall inter-site reproducibility greater than 95% for the isolates tested.

2

Clinical Studies

Clinical, stock and challenge isolates were tested across multiple geographically diverse sites across the United States to demonstrate the performance of the Phoenix antimicrobial susceptibility test with the Phoenix panel formats containing antimicrobial agents. Phoenix System results for Challenge set isolates were compared to the expected results. Phoenix System results for clinical isolates were compared to the results obtained from the CLSI reference broth microdilution method.

The performance of the Phoenix System was assessed by calculating Essential Agreement (EA) and Category Agreement (CA) to expected/reference results for all isolates tested. Essential Agreement (EA) occurs when the BD Phoenix™ Automated Microbiology System agrees exactly or within ± one two-fold dilution to the reference result. Category Agreement (CA) occurs when the BD Phoenix™ Automated Microbiology System agrees with the reference method with respect to the FDA categorical interpretive criteria (susceptible, intermediate, and resistant).

Table 1 summarizes the performance for the isolates tested in this study.

Table 1: Performance of BD Phoenix System by Drug

AntimicrobialConcentrationEA (n)EA (%)CA (n)CA (%)
Cefepime0.5-64 μg/mL178995.2178992.9
Ceftriaxone0.5-64 μg/mL187295.8187290.9

Conclusions Drawn from Substantial Equivalence Studies

The data collected from the substantial equivalence studies demonstrate that testing on the BD Phoenix™ Automated Microbiology System with this antimicrobial agent is substantially equivalent as outlined in the FDA draft guidance document, "Class II Special Controls Guidance Document: Antimicrobial Susceptibility Test (AST) Systems: Guidance for Industry and FDA." February 5, 2003. Technological characteristics of this system are substantially equivalent to those used in the VITEK® system, which received approval by the FDA under PMA number N50510 and BD Phoenix™ Automated Microbiology System with Gatifloxacin (K020321, May 23, 2002), Cefepime-0.5-64 µg/mL (K032675, March 1, 2004) and Ceftriaxone -0.5-64 µg/mL (K032655, October 6, 2003).

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DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo features a stylized depiction of an eagle or bird-like figure with outstretched wings. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES, USA" is arranged in a circular fashion around the emblem.

Food and Drug Administration 2098 Gaither Road Rockville MD 20850

APR 1 2 2006

Ms. Monica E. Giguere Regulatory Affairs Specialist BD Diagnostic Systems 7 Loveton Circle Sparks. MD 21152

Re: K060444/ S1

Trade/Device Name: BD Phoenix™ Automated Microbiology System Cefepime (0.5-64 ug/mL) and Ceftriaxone (0.5-64 ug/mL) on Gram-negative ID/AST or AST Regulation Number: 21 CFR 866.1645 Regulation Name: Fully Automated Short Term Incubation Cycle Antimicrobial Susceptibility Devices Regulatory Class: Class II Product Code: LON Dated: February 20, 2006 Received: February 21, 2006

Dear Ms. Giguere:

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,

Sales, a Forg

Sally A. Hojvat, M.Sc., Ph.D. Director Division of Microbiology Devices Office of In Vitro Diagnostic Device Evaluation and Safety Center for Devices and Radiological Health

Enclosure

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Page 1 of 2

510(k) Number: K060444(S)

Device Name: BD Phoenix™ Automated Microbiology System for use with the antimicrobial agent Cefepime (0.5-64 µg/mL) and Ceftriaxone (0.5-64 µg/mL) on Gram-negative ID/AST or AST only Phoenix panels with additional organism groups

Indications for Use:

The BD Phoenix™ Automated Microbiology System is intended for in vitro quantitative determination of antimicrobial susceptibility by minimal inhibitory concentration (MIC) of most Gram-negative aerobic and facultative anaerobic bacteria isolates from pure culture for Enterobacteriaceae and Non-Enterobacteriaceae and most Gram-positive bacteria isolates from pure culture belonging to the genera Staphylococcus, Enterococcus, and Streptococcus.

This premarket notification is for additional organism groups and BD Phoenix™ Automated Microbiology System with cefepime (0.5-64 µg/mL) and ceftriaxone (0.5-64 µg/mL) on Gramnegative ID/AST or AST only Phoenix panels.

Cefepime has been shown to be active in vitro against most strains of microorganisms listed below, as described in the FDA-approved package insert for this antimicrobial agent.

Active In Vitro and in Clinical Infections Against:

Pseudomonas aeruginosa

Enterobacter species Escherichia coli Klebsiella pneumoniae

Active In Vitro Against:

Acinetobacter lwoffi Citrobacter koseri Citrobacter freundii Hafnia alvei Klebsiella oxytoca Morganella morganii Pantoea agglomerans Providencia rettgeri Providencia stuartii Serratia marcescens

Division Sign-Off

Signature illegible for Sally Hojjat

Office of In Vitre Diagnostic Device Evaluation and Safety

-10(k)_

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Ceftriaxone has been shown to be active in vitro against most strains of microorganisms listed below, as described in the FDA-approved package insert for this antimicrobial agent.

Active In Vitro and in Clinical Infections Against:

Acinetobacter calcoaceticus Enterobacter aerogenes Enterobacter cloacae Escherichia coli

Klebsiella oxytoca Klebsiella pneumoniae Morganella morganii Proteus mirabilis

Serratia marcescens Pseudomonas aeruginosa

Active In Vitro Against:

Citrobacter koseri (formerly C. diversus) Citrobacter freundii Providencia species (including Providencia rettgeri) Salmonella species Shigella species

Prescription Use (Per 21 CFR 801.109) Over-the-Counter Use

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

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Division Sign-Off

Office of In Vitro Diagnostic Device Evaluation and Safety

510(k) K060444/SCC1