K Number
K072717
Device Name
DIMENSION VISTA SYSTEM BILIRUBIN CALIBRATOR, MODEL KC210
Manufacturer
Date Cleared
2007-12-12

(78 days)

Product Code
Regulation Number
862.1150
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The BILI CAL is an in vitro diagnostic product for the calibration of the Direct Bilirubin (DBIL) and Total Bilirubin (TBIL) methods on the Dimension Vista® System.
Device Description
The BILI calibrator is a two level calibrator. Level 1, purified system water, is provided on-board the Dimension Vista® System. Level 2 is a liquid, bovine serum albumin based material spiked with ditaurobilirubin and traceable to NIST Standard Reference Material 916a.
More Information

Not Found

No
The 510(k) summary describes a calibrator for a diagnostic system, not a device that processes data or images using AI/ML. The "Mentions AI, DNN, or ML" section is explicitly marked as "Not Found".

No
The device is an in vitro diagnostic product used for the calibration of bilirubin methods on an analytical system. It does not directly treat or diagnose a condition in a patient.

Yes.
The "Intended Use / Indications for Use" section explicitly states that "The BILI CAL is an in vitro diagnostic product."

No

The device is a calibrator, which is a physical substance used to calibrate laboratory equipment. The description explicitly mentions "purified system water" and "liquid, bovine serum albumin based material," 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: "The BILI CAL is an in vitro diagnostic product for the calibration of the Direct Bilirubin (DBIL) and Total Bilirubin (TBIL) methods on the Dimension Vista® System."

This statement directly identifies the device as an in vitro diagnostic product.

N/A

Intended Use / Indications for Use

The BILI CAL is an in vitro diagnostic product for the calibration of Direct Bilirubin (DBIL) and Total Bilirubin (TBIL) methods on the Dimension Vista® System.

Product codes

JIT

Device Description

The BILI calibrator is a two level calibrator. Level 1, purified system water, is provided on-board the Dimension Vista® System. Level 2 is a liquid, bovine serum albumin based material spiked with ditaurobilirubin and traceable to NIST Standard Reference Material 916a.

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)

Not Found

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

Not Found

Predicate Device(s)

K061719

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 862.1150 Calibrator.

(a)
Identification. A calibrator is a device intended for medical purposes for use in a test system to establish points of reference that are used in the determination of values in the measurement of substances in human specimens. (See also § 862.2 in this part.)(b)
Classification. Class II (special controls). The device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 862.9.

0

510(k) Summary for Dimension Vista® System Bilirubin Calibrator (BILI ČAL - KC210)

510 (k) Number:K072717DEC 1 2 2007
Analyte:Bilirubin
Type of Test:Calibrator Material
Applicant:Dade Behring Inc .
P.O. Box 6101
Newark, DE 19714-6101
Helen M. Lee Regulatory Affairs and Compliance Manager
Office Phone: 302.631.8706
Fax: 302.631.6299
Proprietary and Established Name:Dimension Vista® System Bilirubin Calibrator (BILI CAL - KC210)
Regulatory Information:Regulation Section: 21 CFR § 862.1150 - Calibrator
Classification: Class II
Product Code: JIT - Calibrator, Secondary
Panel: Clinical Chemistry
Intended Use:The BILI CAL is an in vitro diagnostic product for the calibration of
Direct Bilirubin (DBIL) and Total Bilirubin (TBIL) methods on the
Dimension Vista® System.
Device Description:The BILI calibrator is a two level calibrator. Level 1, purified system
water, is provided on-board the Dimension Vista® System. Level 2 is
a liquid, bovine serum albumin based material spiked with
ditaurobilirubin and traceable to NIST Standard Reference Material
916a.

1

510(k) Summary for Dimension Vista® System Bilirubin Calibrator (BILI CAL - KC210)

Substantial Equivalence Information:

Predicate Device: Dimension Vista™ System TBIL Flex reagent cartridge and TDBIL Calibrator (K061719).

Comparison to the Predicate Device:

| Attribute | Dimension Vista™ System
TDBIL Calibrator (Predicate) | Dimension Vista® System
BILI Calibrator (Proposed) |
|------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Intended Use | The TDBIL CAL is an in vitro diagnostic product for calibration of the Direct Bilirubin (DBIL) and Total Bilirubin (TBIL) methods on the Dimension Vista™ System. | The BILI CAL is an in vitro diagnostic product for calibration of the Direct Bilirubin (DBIL) and Total Bilirubin (TBIL) methods on the Dimension Vista® System. |
| Analyte | Ditaurobilirubin | Ditaurobilirubin |
| Matrix | Human Serum | Bovine Serum |
| Levels | One (CAL A) | One (CAL A) |
| Bilirubin Concentration in (mg/dL) | Level 1- is on-board, purified system water | Level 1- is on-board, purified system water |
| Total (TBIL)
Direct (DBIL) | Level 2 (27.5)
Level 2 (19.25) | Level 2 (27.5)
Level 2 (17.5) |
| Form | Lyophilized | Liquid |
| Volume | 3 vials, 1 mL each vial (hydrated volume) | 3 vials, 2.5 mL each |
| Traceability | National Institute of Standards and Technology (NIST), Standard Reference Material (SRM) 916a. | National Institute of Standards and Technology (NIST), Standard Reference Material (SRM) 916a |

Comments on Substantial Equivalence:

Both the proposed Dade Behring Dimension Vista® BILI Calibrator and the existing Dimension Vista® TDBIL Calibrator are in vitro diagnostic products for calibrating the DBIL and TBIL methods.

Conclusion:

The Dimension Vista® BILI Calibrator is substantially equivalent to the Dimension Vista™ TDBIL Calibrator based upon the comparison discussed above.

2

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Public Health Service

DEC 1 2 2007

Food and Druq Administration 2098 Gaither Road Rockville MD 20850

Dade Behring Inc. c/o Ms. Helen M. Lee. Regulatory Affairs & Compliance Manager P.O. Box 6101, Mail Box 514 Newark, DE 19714-6101

Re: K072717

Trade Name: Dimension Vista® System Bilirubin Calibrator (BILI CAL - KC210) Regulation Number: 21 CFR 862.1150 Regulation Name: Calibrator Regulatory Class: Class II Product Code: JIT Dated: November 05, 2007 Received: November 06, 2007

Dear Ms. Lee:

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 (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 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 and 809); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820).

3

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) 276-0490. 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 (240) 276-3150 or at its Internet address at http://www.fda.gov/cdrh/industry/support/index.html.

Sincerely yours.

Jean M. Cooper, M.S., D.V.M.

Jean M. Cooper, M.S., D.V.M. Director Division of Chemistry and Toxicology Office of In Vitro Diagnostic Device Evaluation and Safety Center for Devices and Radiological Health

Enclosure

4

Indications for Use Statement

510(k) Number (if known): K072717

Device Name:

Dimension Vista® System BILI Calibrator (KC210)

Indications for Use:

The BILI CAL is an in vitro diagnostic product for the calibration of the Direct Bilirubin (DBIL) and Total Bilirubin (TBIL) methods on the Dimension Vista® System.

Prescription Use × (Per 21 CFR 801 Subpart D) Over-The-Counter-Use _________________________________________________________________________________________________________________________________________________________ (21 CFR 801)

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

Concurrence of CDRH, Office of In Vitro Diagnostic Devices (OIVD)

Carol C. Benson
Sign-Off

Office of In Vitro Diagnostic Device untion and Safety ,

K072717

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