K Number
K060481
Device Name
LIBERTY GLUCOSE CONTROL SOLUTION
Date Cleared
2006-03-09

(14 days)

Product Code
Regulation Number
862.1660
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
For in vitro diagnostic use (i.e. for external use only) by healthcare professionals and in the home by people with diabetes mellitus to assess the performance of the TheraSense FreeStyle Blood Glucose System.
Device Description
The Liberty Glucose Control consists of a viscosityadjusted, aqueous liquid control solution containing a known quantity of glucose. The product is packaged in plastic dropper tipped bottles for easy application of the control solutions to the test strips and a red coloration to aid the user to visually confirm application of the control. The product is nonhazardous and contains no human or animal derived materials.
More Information

Not Found

No
The device description and performance studies focus on the chemical composition and stability of a glucose control solution, with no mention of AI or ML technologies.

No
The device is a control solution for in vitro diagnostic use, intended to assess the performance of a blood glucose system, not to treat or prevent disease directly.

No

The device is a glucose control solution, not a diagnostic device itself. It is used to assess the performance of a blood glucose system (a diagnostic device), serving as a quality control measure.

No

The device description clearly states it is a "viscosity-adjusted, aqueous liquid control solution" packaged in "plastic dropper tipped bottles," indicating it is a physical product, not software.

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

The "Intended Use / Indications for Use" section explicitly states: "For in vitro diagnostic use".

Furthermore, the device description and intended use align with the definition of an IVD, as it is a control solution used to assess the performance of a blood glucose monitoring system, which is itself an IVD used for diagnosing and monitoring diabetes.

N/A

Intended Use / Indications for Use

For in vitro diagnostic use (i.e. for external use only) by healthcare professionals and in the home by people with diabetes mellitus to assess the performance of the TheraSense FreeStyle Blood Glucose System.

Product codes

75 JJX

Device Description

The Liberty Glucose Control consists of a viscosityadjusted, aqueous liquid control solution containing a known quantity of glucose. The product is packaged in plastic dropper tipped bottles for easy application of the control solutions to the test strips and a red coloration to aid the user to visually confirm application of the control. The product is nonhazardous and contains no human or animal derived materials.

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 and in the home by people with diabetes mellitus

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

Tests were performed to verify specific performance characteristics:

  1. Stability (Accelerated and Real-time)
  2. Open Vial
  3. Microbial Stress Stability
  4. Test precision
    Conclusion: Comparison of the performance characteristics, formulation and intended use support the claim of substantial equivalence.

Key Metrics

Not Found

Predicate Device(s)

K031260, K052980

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 862.1660 Quality control material (assayed and unassayed).

(a)
Identification. A quality control material (assayed and unassayed) for clinical chemistry is a device intended for medical purposes for use in a test system to estimate test precision and to detect systematic analytical deviations that may arise from reagent or analytical instrument variation. A quality control material (assayed and unassayed) may be used for proficiency testing in interlaboratory surveys. This generic type of device includes controls (assayed and unassayed) for blood gases, electrolytes, enzymes, multianalytes (all kinds), single (specified) analytes, or urinalysis controls.(b)
Classification. Class I (general controls). Except when intended for use in donor screening tests, quality control materials (assayed and unassayed) are exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 862.9.

0

K 060481

2006 MAR 9

    1. 510(k) Summary
      MAR 9 2006
  • Introduction: According to the requirements of 21 CFR 807.92, the following information provides sufficient detail to understand basis for a the determination of substantial equivalence. Submitter: Liberty Healthcare Group, Inc. 8883 Liberty Lane Port St. Luce, FL 34952 Contact Person: John C. Gormley American Biological Technologies, Inc. 940 Crossroads Blvd Seguin, TX 78155 (830) 372-1391 ex. 210 Establishment Registration Number: 1643621 Device Name: Liberty Glucose Control . Common Name: Single Analyte Control Solution, All Types (Assayed and Unassayed) Quality Control Material (assayed and unassayed). Classification Name: Classification: Class I per 21 CFR 862.1660 Product Code: 75 JJX Panel: Chemistry Predicate Devices: Name: TheraSense FreeStyle Control Manufacturer: TheraSense, Inc. 510(k) No.: K031260 Name: Liberty Glucose Control Manufacturer: Liberty Healthcare Group, Inc. 510(k) No.: K052980

1

  • Device Description: The Liberty Glucose Control consists of a viscosityadjusted, aqueous liquid control solution containing a known quantity of glucose. The product is packaged in plastic dropper tipped bottles for easy application of the control solutions to the test strips and a red coloration to aid the user to visually confirm application of the control. The product is nonhazardous and contains no human or animal derived materials.
  • Intended Use: The Liberty Glucose Control is intended for in vitro diagnostic use (i.e. for external use only) by healthcare professionals and in the home by people with diabetes mellitus to assess the performance of TheraSense FreeStyle Blood Glucose Monitor.

Comparison to Predicate Device:

| Characteristic/

AspectPredicate Device No. 1Predicate Device No. 2New Product
NameTheraSense FreeStyle
ControlLiberty Glucose ControlLiberty Glucose
Control
510(k), DateK031260, 12/19/2003K052980 11/30/2005
Number of
Levels111
AnalyteGlucoseGlucoseGlucose
ContainerPlastic bottle with
dropper-tipPlastic bottle with dropper
tipPlastic bottle with
dropper tip
Fill Volume4.0 mL3.6 mL3.6 mL
ColorRedRedRed
MatrixBuffered aqueous
solution of D-Glucose,
viscosity modifier,
preservatives, and other
non-reactive ingredientsBuffered aqueous
solution of D-Glucose, a
viscosity modifier,
preservatives, and other
non-reactive ingredientsBuffered aqueous
solution of D-Glucose, a
viscosity modifier,
preservatives, and
other non-reactive
ingredients
Indications for
UseTo use with FreeStyle
Blood Glucose
Monitoring System for
quality control purposes
to verify that the
FreeStyle Meter and
Test Strips are working
right.Used to check the
performance of
Medisense Blood
Glucose Systems only.Used to check the
performance of
FreeStyle Blood
Glucose Systems.
Target
PopulationProfessional and home
useProfessional and home
useProfessional and
home use

2

Performance Studies: Tests were performed to verify specific performance characteristics:

    1. Stability (Accelerated and Real-time)
    1. Open Vial
    1. Microbial Stress Stability
    1. Test precision

Conclusion: Comparison of the performance characteristics, formulation and intended use support the claim of substantial equivalence.

3

510(k) Premarket Notification: Liberty Glucose Control American Biological Technologies, Inc.

6. Truthful and Accuracy Statement

This section contains the Truthful and Accurate Statement.

4

Image /page/4/Picture/11 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized eagle with three stripes forming its wing and tail. The eagle is positioned to the right of a circular arrangement of text that reads "DEPARTMENT OF HEALTH & HUMAN SERVICES USA".

Food and Drug Administratio 2098 Gaither Road Rockville MD 20850

Liberty Healthcare Group, Inc. c/o Mr. John Gromley Vice President Quality Assurance/ Regulatory Affairs American Biological Technologies, Inc. 940 Crossroads Blvd. Seguin, TX 78155

Re: K060481 Trade/Device Name: Liberty Glucose Control Regulation Number: 21 CFR& 862.1660 Regulation Name: Quality control material (assayed and unassayed) Regulatory Class: Class I Product Code: JJX Dated: February 14, 2006 Received: February 23, 2006

Dear Mr. Gromley:

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).

2006 MAR 9

5

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,

Alberto Gutz

Alberto Gutierrez, Ph.D. Director Division of Chemistry and Toxicology Office of In Vitro Diagnostic Device Evaluation and Safety Center for Devices and Radiological Health

Enclosure

6

Indications for Use

510(k) Number (if known): K060481

Device Name: Liberty Glucose Control

Indications For Use:

For in vitro diagnostic use (i.e. for external use only) by healthcare professionals and in the home by people with diabetes mellitus to assess the performance of the TheraSense FreeStyle Blood Glucose System.

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

Over-The-Counter Use X (21 CFR 801 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)

Carol Benam
Division Sign-Off

Office of In Vitro Dlagnostic Device Evaluation and Safety

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