K Number
K062957
Device Name
FASTPACK TOTAL PSA METHOD VERIFICATION KIT
Manufacturer
Date Cleared
2007-04-02

(185 days)

Product Code
Regulation Number
862.1660
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The FastPack® Total PSA Method Verification Kit consists of assayed quality control materials for verification of the calibration and reportable range of the FastPack® Total PSA Immunoassay to meet CLIA requirements.
Device Description
The FastPack® PSA Method Verification Kit The FastPack® Total PSA Method Verification kit components are in liquid form, in vials, from which the user can directly remove sample. They are formulated at three (3) levels packaged together as a kit.
More Information

Not Found

Not Found

No
The summary describes a quality control kit for an immunoassay, which is a chemical analysis method. There is no mention of AI or ML in the intended use, device description, or any other section. The "Mentions AI, DNN, or ML" field is explicitly marked as "Not Found".

No.
The device is a quality control material intended for verifying the calibration and reportable range of an immunoassay, not for treating or diagnosing a medical condition.

No
Explanation: The device is a "Method Verification Kit" used for quality control and calibration verification of an immunoassay, not for diagnosing patient conditions.

No

The device description explicitly states the components are in liquid form, in vials, indicating a physical, non-software-only product.

Based on the provided information, this device is an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use explicitly states that the kit consists of "assayed quality control materials for verification of the calibration and reportable range of the FastPack® Total PSA Immunoassay". This indicates that the materials are used in vitro (outside the body) to assess the performance of another diagnostic test (the FastPack® Total PSA Immunoassay).
  • Device Description: The description mentions the components are in "liquid form, in vials, from which the user can directly remove sample". This further supports the idea that these are reagents or materials used in a laboratory setting for testing.
  • Purpose: The purpose is to "meet CLIA requirements" for verifying the performance of a diagnostic immunoassay. This is a common function of IVD quality control materials.

While the document doesn't explicitly state "In Vitro Diagnostic Device," the intended use and description clearly align with the definition of an IVD, specifically a quality control material used with an IVD immunoassay.

N/A

Intended Use / Indications for Use

The FastPack® Total PSA Method Verification Kit consists of assayed quality control materials for verification of the calibration and reportable range of the FastPack® Total PSA Immunoassay to meet CLIA requirements.

Product codes

JJX

Device Description

FastPack® PSA Method Verification Kit
The FastPack® Total PSA Method Verification kit components are in liquid form, in vials, from which the user can directly remove sample. They are formulated at three (3) levels packaged together as a kit.

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

Not Found

Key Metrics

Not Found

Predicate Device(s)

FastPack® Controls

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

K062957

APR - 2 2007

510(k) Summary

FastPack® Total PSA Method Verification Kit

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

| 1. | Submitter
name, address,
contact | Qualigen, Incorporated
2042 Corte del Nogal
Carlsbad, CA 92011 | |
|----|----------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------------|
| | | Telephone:
Fax: | (760) 918-9165
(760) 918-9127 |
| | | Contact Person: | Melissa Saam |
| | | Date Prepared: | September 28, 2006 |
| 2. | Device name | Proprietary name: | FastPack® Total PSA Method Verification Kit |
| | | Common name: | Total PSA Quality Controls |
| | | Classification Name: | Single (specified) Analyte Controls (assayed and
unassayed) |
| 3. | Predicate
device | FastPack® Controls | |
| 4. | Device
description | FastPack® PSA Method Verification Kit
The FastPack® Total PSA Method Verification kit components are in liquid
form, in vials, from which the user can directly remove sample. They are
formulated at three (3) levels packaged together as a kit. | |
| 5. | Intended use | The FastPack® Total PSA Method Verification Kit consists of assayed
quality control materials for verification of the calibration and reportable
range of the FastPack® Total PSA Immunoassay to meet CLIA
requirements. | |

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The following table compares the FastPack® PSA Method Verification Kit 6. Comparison with the FastPack® Calibrators. to Predicate

·

:

.

Device

FeaturePredicate DeviceNew Device
FastPack® ControlsFastPack® Total PSA
Method Verification Kit
Intended UseAssayed quality control
materials for the verification
of the accuracy and
precision of the FastPack®
Analyzer system when used
for the quantitative
determination of PSA in
human serum or plasma.Assayed quality control
materials for the
verification of the
calibration and reportable
range of the FastPack®
Total PSA Immunoassay
to meet CLIA
requirements.
AnalytesTotal PSATotal PSA
MatrixBovine Serum AlbuminBovine Serum Albumin
FormLiquidLiquid
Volume5.0 mL5.0 mL
Levels23
PSA2 ng/mL0 ng/mL
Concentrations10 ng/mL25 ng/mL
50 ng/mL

:

:

:

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Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo is circular and features the department's name around the perimeter. In the center of the logo is an abstract image of an eagle.

Food and Drug Administration 2098 Gaither Road Rockville MD 20850

APR - 2 2007

Qualigen, Inc. c/o Ms. Melissa Saam Manager, QA/RA 2042 Corte Del Nogal Carlsbad, CA 92011

Re: K062957

Trade/Device Name: Qualigen™ FastPack® Total PSA Method Verification Kit Regulation Number: 21 CFR 862.1660 Regulation Name: Quality control material (assayed and unassayed) Regulatory Class: Class I Product Code: JJX Dated: March 13, 2007 Received: March 19, 2007

Dear Ms. Saam:

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 the Code of Federal Regulations, 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 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 Part 801); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820). This letter will allow you to begin marketing your device as described in your Section 510(k) premarket notification. The

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Page 2 –

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) 276-0450. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 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 (240) 276-3150 or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.

Sincerely yours,

ia M chan
for Dr Robert Becker

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

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Indications for Use

510(k) Number (if known):

K062957

Device Name: FastPack® Total PSA Method Verification Kit

Indications for Use:

The FastPack® Total PSA Method Verification Kit consists of assayed quality control materials for verification of the calibration and reportable range of the FastPack® Total PSA Immunoassay to meet CLIA requirements.

Prescription Use) × (Part 21 CFR 801 Subpart D) AND/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 Device Evaluation (ODE)

Mona M. Chan
Division Sign-Off

510(k)

Office of In Vitro Diagnostic Device Evaluation and Safety

062957

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