K Number
K071737
Device Name
GENERAL SEMEN ANALYSIS KIT
Date Cleared
2007-10-25

(121 days)

Product Code
Regulation Number
864.5220
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The GSA kit is for the evaluation of human semen and provides a set of reagents to evaluate semen quality by measuring five parameters, recommended by the World Health Organization (WHO), that are used to determine whether infertility is caused by abnormalities of one or more of them. The parameters include: Sperm Count, sperm motility, sperm viability, white blood cell (WBC) count, and Sperm head morphology (the subject of this 510(k) submission.
Device Description
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More Information

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No
The document explicitly states "Mentions AI, DNN, or ML: Not Found" and provides no other information suggesting the use of these technologies.

No.
The device is used for the evaluation of human semen to determine whether infertility is caused by abnormalities, which is a diagnostic purpose, not a therapeutic one.

Yes

The device evaluates human semen quality by measuring parameters recommended by the WHO to determine if infertility is caused by abnormalities. This process of identifying abnormalities to understand the cause of a condition (infertility) is a diagnostic function.

No

The summary describes a "GSA kit" which includes "a set of reagents" for evaluating semen. Reagents are physical substances, indicating the device is not software-only.

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

Here's why:

  • Intended Use: The intended use explicitly states that the kit is "for the evaluation of human semen" and "provides a set of reagents to evaluate semen quality by measuring five parameters... used to determine whether infertility is caused by abnormalities". This clearly indicates the device is intended for use in vitro (outside the body) to examine a biological sample (human semen) for diagnostic purposes (evaluating semen quality to help determine the cause of infertility).
  • Sample Type: The device analyzes "human semen," which is a biological specimen.
  • Parameters Measured: The parameters measured (Sperm Count, sperm motility, sperm viability, white blood cell (WBC) count, and Sperm head morphology) are all standard laboratory tests performed on biological samples to aid in diagnosis.

The lack of information in other sections (Device Description, image processing, AI/ML, etc.) does not negate the clear indication from the Intended Use that this is an IVD.

N/A

Intended Use / Indications for Use

The GSA kit is for the evaluation of human semen and provides a set of reagents to evaluate semen quality by measuring five parameters, recommended by the World Health Organization (WHO), that are used to determine whether infertility is caused by abnormalities of one or more of them.

The parameters include: Sperm Count, sperm motility, sperm viability, white blood cell (WBC) count, and Sperm head morphology (the subject of this 510(k) submission.

Product codes

GKZ

Device Description

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Mentions image processing

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Mentions AI, DNN, or ML

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Input Imaging Modality

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Anatomical Site

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Indicated Patient Age Range

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Intended User / Care Setting

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Description of the training set, sample size, data source, and annotation protocol

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Description of the test set, sample size, data source, and annotation protocol

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Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

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

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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.

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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.

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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).

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§ 864.5220 Automated differential cell counter.

(a)
Identification. An automated differential cell counter is a device used to identify one or more of the formed elements of the blood. The device may also have the capability to flag, count, or classify immature or abnormal hematopoietic cells of the blood, bone marrow, or other body fluids. These devices may combine an electronic particle counting method, optical method, or a flow cytometric method utilizing monoclonal CD (cluster designation) markers. The device includes accessory CD markers.(b)
Classification. Class II (special controls). The special control for this device is the FDA document entitled “Class II Special Controls Guidance Document: Premarket Notifications for Automated Differential Cell Counters for Immature or Abnormal Blood Cells; Final Guidance for Industry and FDA.”

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Public Health Service

Food and Drug Administration 2098 Gaither Road Rockville MD 20850

Dyn-Bioshaf (2006) Ltd. C/O Thomas M. Tsakeris Devices & Diagnostics Consulting Group, Inc. 16809 Briardale Road Rockville, Maryland 20855

OCT 2 5 2007

Re: K071737

Trade/Device Name: General Semen Analysis Kit Regulation Number: 21 CFR 864.5220 Regulation Name: Automated differential cell counter Regulatory Class: Class II Product Code:GKZ Dated: June 26, 2007 Received: June 26, 2007

Dear Mr. Tsakeris:

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). 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

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predicate device results in a classification 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 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" (21CFR Part 807.97). For questions regarding postmarket surveillance, please contact CDRH's Office of Surveillance and Biometric's (OSB's) Division of Postmarket Surveillance at (240) 276-3474. For questions regarding the reporting of device adverse events (Medical Device Reporting (MDR)), please contact the Division of Surveillance Systems at (240) 276-3464. 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,

Robert H. Borker/

Robert L. Becker, Jr., M.D., Ph.D. Director Division of Immunology and Hematology Office of In Vitro Diagnostic Device Evaluation and Safety Center for Devices and Radiological Health

Enclosure

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Indication for Use

510(k) Number (if known): K071737

Device Name: General Semen Analysis (GSA) Kit

Indication for Use:

The GSA kit is for the evaluation of human semen and provides a set of reagents to evaluate semen quality by measuring five parameters, recommended by the World Health Organization (WHO), that are used to determine whether infertility is caused by abnormalities of one or more of them.

The parameters include: Sperm Count, sperm motility, sperm viability, white blood cell (WBC) count, and Sperm head morphology (the subject of this 510(k) submission.

Prescription Use X And/Or (21 CFR Part 801 Subpart D)

Over the Counter Use (21 CFR Part 801 Subpart C)

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

Concurrence of CDRH, Office of In Vitro Diagnostic Device Evaluation and Safety (OVD)

Touphine Bautista

Division Sign/Off

Office of In Vitro Diagnostic Device Evaluation and Safety

510(k) K071737