K Number
K062581
Device Name
OLYMPUS TSH REAGENT, CALIBRATOR AND CONTROL AND AU3000I IMMUNOASSAY SYSTEM
Date Cleared
2006-11-29

(90 days)

Product Code
Regulation Number
862.1690
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Olympus thyroid stimulating hormone (TSH) assay is a paramagnetic particle, chemiluminescent immunoassay for the quantitative determination of TSH levels in human serum and plasma using the Olympus AU3000i™ Immunoassay System. Measurements of TSH produced by the anterior pituitary are used in the diagnosis of thyroid or pituitary disorders. The Olympus TSH Calibrator is used for calibrating the quantitative Olympus TSH Assay on the Olympus AU3000i Immunoassay System. The Olympus TSH Control is used for quality control of the Olympus TSH test system on the Olympus AU3000i Immunoassay System. The Olympus AU3000i Immunoassay System is a chemiluminescent discrete photometric chemistry analyzer for the quantitative determination of analytes in human serum and plasma.
Device Description
The Olympus TSH assay is a two-step paramagnetic particle enzyme immunoassay. It is based on the sandwich principle and used to quantitate TSH in serum/plasma. The Olympus TSH assay reagent and sample are added to the assay cuvette in the following sequence: 1. Samples are incubated first with a monoclonal anti-TSH antibody bound to paramagnetic particles. 2. After a washing step, a second monoclonal anti-TSH antibody conjugated with alkaline phosphatase is added. The TSH reacts with the paramagnetic particles and the conjugated antibody to form a sandwich complex. Washing steps remove the unbound material. 3. The chemiluminescent substrate is added to the assay cuvette and reacts with the bound alkaline phosphatase (ALP). Light generated by the reaction is measured by the luminometer. The light emission is proportional to the quantity of TSH in the sample. 4. Results are calculated from a pre-defined calibration curve. The Olympus AU3000i system automatically calculates the TSH concentration of each sample in mIU/L or µIU/mL.
More Information

No
The description details a standard immunoassay process and a photometric analyzer. There is no mention of AI or ML algorithms for data analysis, interpretation, or system control. The results are calculated from a pre-defined calibration curve, which is a traditional method.

No
The device is an in vitro diagnostic (IVD) assay designed to quantitatively determine TSH levels for diagnostic purposes, not to treat or alleviate a medical condition.

Yes

The "Intended Use / Indications for Use" section explicitly states that "Measurements of TSH produced by the anterior pituitary are used in the diagnosis of thyroid or pituitary disorders." This indicates that the device is intended to aid in the diagnosis of medical conditions.

No

The device is an immunoassay kit and an immunoassay system, which are hardware components used for laboratory testing. While the system includes software for calculation, the core device is not software-only.

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

Here's why:

  • Intended Use: The intended use explicitly states "for the quantitative determination of TSH levels in human serum and plasma". This is a classic definition of an in vitro diagnostic test, as it analyzes biological samples outside of the body to provide information about a patient's health.
  • Diagnosis: The intended use also states that the measurements are "used in the diagnosis of thyroid or pituitary disorders". This further confirms its role in providing diagnostic information.
  • Device Description: The description details a laboratory-based assay using reagents and a system to analyze serum/plasma samples. This is consistent with the nature of an IVD.
  • Components: The description mentions a calibrator and control, which are essential components of an IVD system used for ensuring accuracy and quality control.
  • Performance Characteristics: The inclusion of performance characteristics like precision, sensitivity, and method comparison are standard for IVD devices, demonstrating their analytical performance.
  • Predicate Devices: The listing of predicate devices, which are also IVDs (Roche Elecsys TSH Assay, CalSet, Control, and analyzer), indicates that this device is intended to perform a similar diagnostic function.

Therefore, based on the provided information, the Olympus thyroid stimulating hormone (TSH) assay, along with its associated calibrator, control, and the Olympus AU3000i Immunoassay System, clearly falls under the definition of an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The Olympus thyroid stimulating hormone (TSH) assay is a paramagnetic particle, chemiluminescent immunoassay for the quantitative determination of TSH levels in human serum and plasma using the Olympus AU3000i™ Immunoassay System.

Measurements of TSH produced by the anterior pituitary are used in the diagnosis of thyroid or pituitary disorders.

The Olympus TSH Calibrator is used for calibrating the quantitative Olympus TSH Assay on the Olympus AU3000i Immunoassay System.

The Olympus TSH Control is used for quality control of the Olympus TSH test system on the Olympus AU3000i Immunoassay System.

The Olympus AU3000i Immunoassay System is a chemiluminescent discrete photometric chemistry analyzer for the quantitative determination of analytes in human serum and plasma.

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

JLW, JIS, JJX, JJE

Device Description

The Olympus TSH assay is a two-step paramagnetic particle enzyme immunoassay. It is based on the sandwich principle and used to quantitate TSH in serum/plasma.

The Olympus TSH assay reagent and sample are added to the assay cuvette in the following sequence:

  1. Samples are incubated first with a monoclonal anti-TSH antibody bound to paramagnetic particles.
  2. After a washing step, a second monoclonal anti-TSH antibody conjugated with alkaline phosphatase is added. The TSH reacts with the paramagnetic particles and the conjugated antibody to form a sandwich complex. Washing steps remove the unbound material.
  3. The chemiluminescent substrate is added to the assay cuvette and reacts with the bound alkaline phosphatase (ALP). Light generated by the reaction is measured by the luminometer. The light emission is proportional to the quantity of TSH in the sample.
  4. Results are calculated from a pre-defined calibration curve. The Olympus AU3000i system automatically calculates the TSH concentration of each sample in mIU/L or µIU/mL.

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)

Comparison to predicate device:
Precision: Subject device sample total CV% is Low 2.9, Med 6.0, High 3.7. Predicate device sample total CV% is Low 8.7, Med 3.3, High 3.6.
Functional Sensitivity: Subject device is 0.0013 µIU/mL, Predicate device is 0.014 µIU/mL.
Analytical Sensitivity: Subject device is 0.0002 µIU/mL, Predicate device is 0.005 µIU/mL.
Measurable Range: Subject device is 0.001 – 130 µIU/mL, Predicate device is 0.005 – 100.0 µIU/mL.
Method Comparison (Passing Bablok): Subject device Intercept -0.0046, Slope 0.935, R 0.9931. Predicate device Intercept 0.01, Slope 1.01, R 0.944.
Applicable Interfering Substances:
Subject device: Bilirubin ≤ 10% @ 40 mg/dL, Hemolysis ≤ 5% @ 5 g/L, Lipemia ≤ 3% @ 10 g/L.
Predicate device: Bilirubin ≤ 10% @ 41 mg/dL, Hemolysis ≤ 10% @ 1 g/dL, Lipemia ≤ 10% @ 1500 mg/dL.
Specificity:
Subject device: LH No significant interference, FSH No significant interference, hGH Not Tested, hCG Not Detected.
Predicate device: LH No significant interference, FSH No significant interference, hGH Not Detected, hCG Not Detected.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

See Summary of Performance Studies.

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.

K961491, K060754, K962573, K961481

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

§ 862.1690 Thyroid stimulating hormone test system.

(a)
Identification. A thyroid stimulating hormone test system is a device intended to measure thyroid stimulating hormone, also known as thyrotrophin and thyrotrophic hormone, in serum and plasma. Measurements of thyroid stimulating hormone produced by the anterior pituitary are used in the diagnosis of thyroid or pituitary disorders.(b)
Classification. Class II.

0

K062581

510(k) Summary

NOV 2 9 2006

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


| 1. | Submitter name,
address, contact | Olympus America
3131 W Royal Lane
Irving, TX 75063

Telephone:
Fax:

Contact Person:
Date Prepared: | (972) 556-9697
(972) 556-0365

David Davis
October 6, 2006 |
|----|-------------------------------------|-----------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| 2. | Device name | Proprietary Name:

Common Name:

Classification Name: | Olympus TSH Reagent
Olympus TSH Calibrator
Olympus TSH Control
Olympus AU3000i™ Immunoassay System

TSH Reagent, Calibrator & Control
Immunoassay Analyzer

Thyroid-Stimulating Hormone Test System,
Calibrator, secondary
Single (specified) analyte control (assayed and
unassayed)
Analyzer, Chemistry (Photometric, Discrete),
For Clinical Use |
| 3. | Predicate device | Reagent:

Calibrator:

Control:

Analyzer: | Roche Elecsys® TSH Assay (K961491)

Roche Elecsys® TSH CalSet (K060754)

Roche Elecsys® PreciControl TSH (K962573)

Roche Elecsys® 2010 analyzer (K961481) |

1

| 4. | Device description | The Olympus TSH assay is a two-step paramagnetic particle enzyme
immunoassay. It is based on the sandwich principle and used to quantitate
TSH in serum/plasma. | | |
|----|--------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--|--|
| | | The Olympus TSH assay reagent and sample are added to the assay
cuvette in the following sequence: | | |
| | | 1. Samples are incubated first with a monoclonal anti-TSH antibody
bound to paramagnetic particles.
2. After a washing step, a second monoclonal anti-TSH antibody
conjugated with alkaline phosphatase is added. The TSH reacts with
the paramagnetic particles and the conjugated antibody to form a
sandwich complex. Washing steps remove the unbound material. | | |
| | | 3. The chemiluminescent substrate is added to the assay cuvette and
reacts with the bound alkaline phosphatase (ALP). Light generated
by the reaction is measured by the luminometer. The light emission is
proportional to the quantity of TSH in the sample.
4. Results are calculated from a pre-defined calibration curve. The | | |
| | | Olympus AU3000i system automatically calculates the TSH
concentration of each sample in mIU/L or µIU/mL. | | |
| 5. | Intended use | The Olympus thyroid stimulating hormone (TSH) assay is a paramagnetic
particle, chemiluminescent immunoassay for the quantitative
determination of TSH levels in human serum and plasma using the
Olympus AU3000i™ Immunoassay System. | | |
| | | Measurements of TSH produced by the anterior pituitary are used in the
diagnosis of thyroid or pituitary disorders. | | |
| | | The Olympus TSH Calibrator is used for calibrating the quantitative
Olympus TSH Assay on the Olympus AU3000i Immunoassay System. | | |
| | | The Olympus TSH Control is used for quality control of the Olympus TSH
test system on the Olympus AU3000i Immunoassay System. | | |
| | | The Olympus AU3000i Immunoassay System is a chemiluminescent
discrete photometric chemistry analyzer for the quantitative determination
of analytes in human serum and plasma. | | |

:

2

    1. Comparison to
      predicate device
      The following tables compare the Olympus TSH Test System with the
      Roche Elecsys® TSH Test System.
ItemAU3000i with TSHRoche Elecsys® TSH
Intended UseQuantitative determination of thyroid stimulating hormone (TSH) levels in human serum/plasmaImmunoassay for the in vitro quantitative determination of thyrotropin in human serum and plasma.
TraceabilityWHOWHO
Detection/Operating PrincipleChemiluminescenceChemiluminescence
Assay MethodologySandwich immunoassaySandwich immunoassay
Solid PhaseMicro-particleMicro-particle
Sample TypeSerum and plasmaSerum and plasma
AntibodyMonoclonal anti-TSH mouse antibodyMonoclonal anti-TSH mouse antibody
Analyzer ReagentsOn-board Storage
Bar-coded (I-D & 2-D) reagent, calibrator & control
Cap/septum for increased reagent stability and evaporation controlOn-board Storage
Bar-coded (1-D & 2-D) reagent, calibrator & control
Cap/septum for increased reagent stability and evaporation control
Reagent, Calibrator and Control storage formLiquidLiquid
Calibration and Control StabilityUnopened
• At 2-8°C up to the stated expiration date
Opened
• 28 days / 4 weeks at 2-8°CUnopened
• At 2-8°C up to the stated expiration date
Opened
• 28 days / 4 weeks at 2-8°C
Control levels and target concentration rangeOne Euthyroid/Hyperthyroid thresholdOne Euthyroid/Hyperthyroid threshold
Control constituentsSingleSingle
Control MatrixHuman serum with added antigenHuman serum with added antigen
Analyzer SystemFully automated
Random access
Computer controlled
Stat capabilityFully automated
Random access
Computer controlled
Stat capability
Analyzer/User InterfaceKeyboard/touch screen control
Colored touch screen monitor
Stationary barcode scanners
Graphical user interface
On line helpKeyboard/touch screen control
Colored touch screen monitor
Stationary barcode scanners
Graphical user interface
On line help
Analyzer ConsumablesDisposable reaction vessels
Disposable sample tipsDisposable reaction vessels
Disposable sample tips
Analyzer Sample DetectionLiquid Level Detection
Clot DetectionLiquid Level Detection
Clot Detection
Analyzer Host InterfaceRS232C bidirectionalRS232C bidirectional
Differences
ItemAU3000i with TSHRoche Elecsys® TSH
Instrument RequiredOlympus AU3000i™
Immunoassay SystemRoche Elecsys and Modular
analytics immunoassay analyzers.
TraceabilityWHO 3rd IS 81/565WHO 2nd IRP 80/558
Calibrator levels and target
ConcentrationOne
Cal: 13 µIU/mLTwo
Cal 1: 0 µIU/mL
Cal 2: 1.5 µIU/Ml
Solid phase binding principleDirect coatingBiotin and streptavidin
Assay Range0.001 – 130 µIU/mL0.005 – 100 µIU/mL
Calibrator MatrixBovine serum human pituitary
TSHHorse serum with added
recombinant TSH
Analyzer Sample Volume10 – 100 µl10 – 50 µl
Analyzer Reagent Positions24 reagent positions
2 diluent/pretreatment positions15 reagent positions
2 diluent/pretreatment positions
Analyzer Throughput240 results/hour88 results/hour

3

Performance Characteristics
ItemAU3000i with TSHRoche Elecsys® TSH
PrecisionSample Total CV%Sample Total CV%
Low 2.9Low 8.7
Med 6.0Med 3.3
High 3.7High 3.6
Functional Sensitivity0.0013 µIU/mL0.014 µIU/mL
Analytical Sensitivity0.0002 µIU/mL0.005 µIU/mL
Measurable Range0.001 – 130 µIU/mL0.005 – 100.0 µIU/mL
Method Comparison (Passing
Bablok)Intercept-0.0046
Slope 0.935
R 0.9931Intercept0.01
Slope 1.01
R 0.944
Applicable Interfering SubstancesBilirubin ≤ 10% @ 40 mg/dL
Hemolysis ≤ 5% @ 5 g/L
Lipemia ≤ 3% @ 10 g/LBilirubin ≤ 10% @ 41 mg/dL
Hemolysis ≤ 10% @ 1 g/dL
Lipemia ≤ 10% @ 1500 mg/dL
SpecificityLH No significant
interference
FSH No significant
interference
hGH Not Tested
hCG Not DetectedLH No significant
interference
FSH No significant
interference
hGH Not Detected
hCG Not Detected

4

Image /page/4/Picture/1 description: The image shows a circular logo with text around the perimeter and a stylized symbol in the center. The text reads "DEPARTMENT OF HEALTH & HUMAN SERVICES USA". The symbol in the center appears to be an abstract representation of an eagle or bird, with three curved lines forming its body and wings.

Public Health Service

Food and Druq Administration 2098 Gaither Road Rockville MD 20850

Mr. David Davis Manager, RA/QA Olympus America, Inc. 3131 West Royal Lane Irving, TX 75063

NOV 2 9 2006

K062581 Re: Trade/Device Name: Olympus TSH (thyroid stimulating hormone) Test System and Olympus AU3000i™ Immunoassay System Regulation Number: 21 CFR 862.1690 Regulation Name: Thyroid stimulating hormone test system ﻣﻌﺪﺩﺳﻤﺴ Regulatory Class: Class II Product Code: JLW, JIS, JJX, JJE Dated: August 28, 2006 Received: August 31, 2006

Dear Mr. Davis: ·

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 cither class II (Spccial 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).

5

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,

Albert 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

009581

510(k) Number (if known):

Device Name:

Olympus TSH (thyroid stimulating hormone) Test System and Olympus AU3000i™ Immunoassay System

Indications for Use:

The Olympus thyroid stimulating hormone (TSH) assay is a paramagnetic particle, chemiluminescent immunoassay for the quantitative determination of TSH levels in human serum and plasma using the Olympus AU3000i™ Immunoassay System.

Measurements of TSH produced by the anterior pituitary are used in the diagnosis of thyroid or pituitary disorders.

The Olympus TSH Calibrator is used for calibrating the quantitative Olympus TSH Assay on the Olympus AU3000i Immunoassay System.

The Olympus TSH Control is used for quality control of the Olympus TSH test system on the Olympus AU3000i Immunoassay System.

The Olympus AU3000i Immunoassay System is a chemiluminescent discrete photometric chemistry analyzer for the quantitative determination of analytes in human serum and plasma.

Prescription Use (Part 21 CFR 801 Subpart D) OR

Over-The-Counter Use (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 Diagnostics Devices (OIVD)

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