K Number
K073029
Device Name
PROFLU+ ASSAY
Manufacturer
Date Cleared
2008-01-04

(67 days)

Product Code
Regulation Number
866.3980
Reference & Predicate Devices
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The ProFlu+™ Assay is a multiplex Real Time RT-PCR in vitro diagnostic test for the rapid and qualitative detection and discrimination of Influenza A Virus, Influenza B Virus, and Respiratory Syncytial Virus (RSV) nucleic acids isolated and purified from nasopharyngeal (NP) swab specimens obtained from symptomatic patients. This test is intended for use to aid in the differential diagnosis of Influenza A, Influenza B and RSV viral infections in humans and is not intended to detect Influenza C.

A negative test is presumptive and it is recommended these results be confirmed by cell culture. Negative results do not preclude influenza or RSV virus infection and should not be used as the sole basis for treatment or other management decisions.

Performance characteristics for Influenza A Virus were established when Influenza A/H3 and A/H1 were the predominant Influenza A viruses in circulation. When other Influenza A viruses are emerging, performance characteristics may vary.

If infections with a novel Influenza A virus are suspected based on current clinical and epidemiological screening criteria recommended by public health authorities, specimens should be collected with appropriate infection control precautions for novel virulent Influenza viruses and sent to state or local health department for testing. Viral culture should not be attempted in these cases unless a BSL 3+ facility is available to receive and culture specimens.

Device Description

The ProFlu+ Assay enables detection and differentiation of Influenza A Virus, Influenza B Virus, Respiratory Syncytial Virus (RSV) (Types A and B), and Internal Control. Nasopharyngeal swab specimens are collected from symptomatic patients using a polyester, rayon or nylon tipped swab and placed into viral transport medium.

An Internal Control (IC) is added to each sample prior to nucleic acid isolation to monitor for inhibitors present in the specimens. The isolation and purification of the nucleic acids is performed using a MagNA Pure LC Instrument (Roche) and the MagNA Pure Total Nucleic Acid Isolation Kit (Roche).

The purified nucleic acids are added to ProFlu+ Supermix along with enzymes included in the ProFlu+ Detection Kit. The ProFlu+ Supermix contains oligonucleotide primers and target-specific oligonucleotide probes. The primers are complementary to highly conserved regions of genetic sequences for these respiratory viruses. The probes are dual-labeled with a reporter dye attached to the 5'-end and a quencher dye attached to the 3'-end (see table below).

Reverse transcription of the RNA in the sample into complementary DNA (cDNA) and subsequent amplification of DNA is performed in a Cepheid SmartCycler® II instrument. In this process, the probe anneals specifically to the template followed by primer extension and amplification. The ProFlu+ Assay is based on Taqman chemistry, which utilizes the 5' - 3' exonuclease activity of the Taq polymerase to cleave the probe thus separating the reporter dye from the quencher. This generates an increase in fluorescent signal upon excitation from a light source. With each cycle, additional reporter dye molecules are cleaved from their respective probes, further increasing fluorescent signal. The amount of fluorescence at any given cycle is dependent on the amount of amplification products present at that time. Fluorescent intensity is monitored during each PCR cycle by the SmartCycler instrument.

AI/ML Overview

Here's an analysis of the acceptance criteria and study details for the ProFlu+ Assay, based on the provided text:

Acceptance Criteria and Device Performance

The acceptance criteria are not explicitly stated in a formalized table within the provided text. However, they can be inferred from the reported sensitivity and specificity values. The study reports the following performance for the ProFlu+ Assay:

Table 1: ProFlu+ Assay Performance (Inferred Acceptance Criteria vs. Reported Performance)

AnalytePerformance MetricImplied Acceptance Criteria (Range/Threshold)Reported Device Performance (95% CI) - Prospective StudyReported Device Performance (95% CI) - Retrospective Study
Influenza ASensitivityHigh (e.g., >95%)100% (97.1% - 100%)100% (56.6% - 100%)
SpecificityHigh (e.g., >90%)92.6% (90.4% - 94.3%)96.4% (87.7% - 99.0%)
Influenza BSensitivityHigh (e.g., >90%)97.8% (88.7% - 99.6%)89.5% (68.6% - 97.1%)
SpecificityHigh (e.g., >95%)98.6% (97.5% - 99.2%)100% (91.4% - 100%)
RSVSensitivityHigh (e.g., >85%)89.5% (75.9% - 95.8%)100% (85.7% - 100%)
SpecificityHigh (e.g., >90%)94.9% (93.2% - 96.2%)97.3% (86.2% - 99.5%)

Reproducibility (Overall Percent Agreement):

  • Implied Acceptance Criteria: High (e.g., >95%)
  • Reported Device Performance: 98% (96% - 99% CI)

Study Details

2. Sample Size and Data Provenance

  • Sample Size for Test Set:
    • Prospective Study: 826 nasopharyngeal (NP) swab samples. A total of 891 samples were initially tested, but 5 unresolved samples were excluded.
    • Retrospective Study: 60 samples.
  • Data Provenance:
    • Prospective Study: 3 U.S. clinical laboratories (prospective collection during February - April 2007 respiratory virus season).
    • Retrospective Study: 1 U.S. site.

3. Number of Experts and Qualifications for Ground Truth

The document does not explicitly state the number of "experts" (e.g., pathologists, radiologists) in the conventional sense for oncology or imaging studies. For this in vitro diagnostic (IVD) device:

  • The "experts" can be considered the laboratory personnel performing the reference methods. The study was conducted at 3 U.S. clinical laboratories and 1 U.S. site, implying multiple trained technicians/scientists.
  • Qualifications: While not explicitly detailed, it is assumed these individuals were qualified laboratory professionals experienced in performing rapid culture (shell vial) and direct fluorescent antibody (DFA) screening and identification for respiratory viruses, as these were the reference methods.

4. Adjudication Method for the Test Set

The adjudication method used for discrepant results was:

  • Discrepant Analysis: For samples where ProFlu+ Assay results and culture results disagreed, RT-PCR with virus-specific primers (obtained from literature) followed by sequencing was performed. This served as the definitive arbiter for these cases.
  • For the 23 DFA Respiratory Virus Screen positive samples that had too few cells for specific identification, genetic sequencing analysis was used to confirm the specific virus or to confirm negativity for Influenza A, Influenza B, and RSV.

5. Multi Reader Multi Case (MRMC) Comparative Effectiveness Study

  • No, an MRMC comparative effectiveness study was not done. This is an in vitro diagnostic device for laboratory analysis, not an imaging device requiring human reader interpretation in a clinical setting in the way MRMC studies are typically performed. The "readers" here are the automated instruments and laboratory technicians, whose performance is assessed through reproducibility and accuracy against reference methods.

6. Standalone (Algorithm Only) Performance

  • Yes, a standalone performance study was done. The entire clinical performance section (both prospective and retrospective studies) evaluates the ProFlu+ Assay as a standalone device, comparing its results directly against reference methods. There is no mention of a "human-in-the-loop" component for its primary diagnostic function.

7. Type of Ground Truth Used

The ground truth for the clinical performance studies was established using a combination of:

  • Reference Methods:
    • Rapid culture (shell vial)
    • Direct fluorescent antibody (DFA) screening and identification
  • Discrepant Analysis/Confirmation:
    • RT-PCR with virus-specific primers followed by sequencing (for resolving disagreements between ProFlu+ and reference methods, and for confirming DFA screen positives with insufficient cells).

Essentially, the ground truth was a combination of established laboratory methods, with molecular sequencing as the definitive arbiter for ambiguous or conflicting results.

8. Sample Size for the Training Set

  • The document does not specify a sample size for a training set. This type of IVD (multiplex Real-Time RT-PCR assay) is developed based on pre-defined molecular targets and amplification conditions. While there would have been extensive assay development and optimization, the concept of a "training set" in the machine learning sense is not directly applicable or explicitly described for an RT-PCR assay in this context. The study focuses on clinical validation of the developed assay.

9. How Ground Truth for Training Set Was Established

  • As a "training set" is not explicitly mentioned or relevant in the context of conventional machine learning for this specific device (a molecular diagnostic assay), the method for establishing ground truth for it is not applicable or described in the document. The assay's design relies on known genetic sequences of the target viruses, and its performance is validated clinically.

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510(k) SUMMARY

October 25, 2007

JAN - 4 203

CONTACT

Dr. Karen Harrington Prodesse, Inc. W229 N1870 Westwood Dr. Waukesha, WI 53186

NAME OF DEVICE

Trade Name: Requlation Number: Classification Name: ProFlu+ Assay 21 CFR 866.3980 Respiratory Virus Panel Multiplex

PREDICATE DEVICE

xTAG Respiratory Viral Panel Luminex Molecular Diagnostics

INTENDED USE

The ProFlu+™ Assay is a multiplex Real Time RT-PCR in vitro diagnostic test for the rapid and qualitative detection and discrimination of Influenza A Virus, Influenza B Virus, and Respiratory Syncytial Virus (RSV) nucleic acids isolated and purified from nasopharynqeal (NP) swab specimens obtained from symptomatic patients. This test is intended for use to aid in the differential diagnosis of Influenza A, Influenza B and RSV viral infections in humans and is not intended to detect Influenza C.

A negative test is presumptive and it is recommended these results be confirmed by cell culture. Negative results do not preclude influenza or RSV virus infection and should not be used as the sole basis for treatment or other management decisions.

Performance characteristics for Influenza A Virus were established when Influenza A/H3 and A/H1 were the predominant Influenza A viruses in circulation. When other Influenza A viruses are emerging, performance characteristics may vary.

If infections with a novel Influenza A virus are suspected based on current clinical and epidemiological screening criteria recommended by public health authorities, specimens should be collected with appropriate infection control precautions for novel virulent Influenza viruses and sent to state or local health department for

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testing. Viral culture should not be attempted in these cases unless a BSL 3+ facility is available to receive and culture specimens.

PRODUCT DESCRIPTION

The ProFlu+ Assay enables detection and differentiation of Influenza A Virus, Influenza B Virus, Respiratory Syncytial Virus (RSV) (Types A and B), and Internal Control. Nasopharyngeal swab specimens are collected from svmptomatic patients using a polvester, rayon or nylon tipped swab and placed into viral transport medium.

An Internal Control (IC) is added to each sample prior to nucleic acid isolation to monitor for inhibitors present in the specimens. The isolation and purification of the nucleic acids is performed using a MagNA Pure LC Instrument (Roche) and the MagNA Pure Total Nucleic Acid Isolation Kit (Roche).

The purified nucleic acids are added to ProFlu+ Supermix along with enzymes included in the ProFlu+ Detection Kit. The ProFlu+ Supermix contains oligonucleotide primers and target-specific oligonucleotide probes. The primers are complementary to highly conserved regions of genetic sequences for these respiratory viruses. The probes are dual-labeled with a reporter dye attached to the 5'-end and a quencher dye attached to the 3'-end (see table below).

AnalyteGene TargetedProbe FluorophoreAbsorbancePeakEmissionPeakInstrumentChannel
Influenza A VirusMatrixFAM495 nm520 nmFAM
RSV APolymeraseCal Orange 560540 nm561 nmTET
RSV BPolymeraseCal Orange 560540 nm561 nmTET
Influenza B VirusNon-structuralNS1 and NS2Cal Red 610595 nm615 nmTexas Red
Internal ControlNAQuasar 670647 nm667 nmCy5

Reverse transcription of the RNA in the sample into complementary DNA (cDNA) and subsequent amplification of DNA is performed in a Cepheid SmartCvcler® II instrument. In this process, the probe anneals specifically to the template followed by primer extension and amplification. The ProFlu+ Assay is based on Tagman chemistry, which utilizes the 5' - 3' exonuclease activity of the Tag polymerase to cleave the probe thus separating the reporter dye from the quencher. This generates an increase in fluorescent signal upon excitation from a light source. With each cycle, additional reporter dye molecules are cleaved from their respective probes, further increasing fluorescent signal. The amount of fluorescence at any given cycle is dependent on the amount of amplification products present at that time. Fluorescent intensity is monitored during each PCR cycle by the SmartCycler instrument.

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SUBSTANTIAL EQUIVALENCE

Clinical Performance

Performance characteristics of the ProFlu+ Assay were established during a prospective study at 3 U.S. clinical laboratories and a retrospective study at 1 U.S. site during the 2007 respiratory virus season (February - April). Samples used for this study were nasopharyngeal (NP) swab specimens that were collected for routine influenza or RSV testing by each site.

The reference method was rapid culture (shell vial) followed by direct fluorescent antibody (DFA) screening and identification.

A total of 891 NP swab samples were tested with the ProFlu+ Assay and by culture. Five (5) samples that initially gave unresolved results remained unresolved upon retesting with the ProFlu+ Assay and are not included in the analysis below. All 5 samples were culture negative.

A total of 23 samples were DFA Respiratory Virus Screen positive (screening reagent detects Influenza A and B, RSV, Parainfluenza 1, 2 and 3 and Adenovirus), but contained too few cells to obtain a specific positive identification. 21 of these 23 samples were also positive by the ProFlu+ Assay (9 Influenza A positive, 11 Influenza B positive and 1 RSV positive) and genetic sequencing analysis confirmed the identification of the specific virus. The other 2 DFA screen positive samples were negative by the ProFlu+ Assay and sequence analysis confirmed that they were negative for Influenza A, Influenza B and RSV; these 2 samples were considered true negatives. Discrepant analysis for samples where ProFlu+ Assay and culture results were in disagreement was performed using RT-PCR with virus specific primers obtained from literature followed by sequencing.

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Results from Prospective Study:

Influenza A Comparison Results

Reference Method
PositiveNegativeTotalComments
Positive12752a179Sensitivity 100% (97.1% - 100%) 95% CI
Negative0647647Specificity 92.6% (90.4% - 94.3%) 95% CI
Total127699826

ª Forty-three (43) samples positive for Influenza A by sequence analysis, 8 samples negative for Influenza A by sequence analysis, and 1 sample unavailable for sequence analysis.

Influenza B Comparison Results

Reference Method
PositiveNegativeTotalComments
ProFlu+AssayPositive4511a56Sensitivity 97.8% (88.7% - 99.6%) 95% CI
ProFlu+AssayNegative1b769770Specificity 98.6% (97.5% - 99.2%) 95% CI
ProFlu+AssayTotal46780826

ª Eleven (11) samples positive for Influenza B by sequence analysis.
º One (1) sample negative for Influenza B by sequence analysis.

One (1) sample negative for Influenza B by sequence analysis.

RSV Comparison Results

Reference Method
PositiveNegativeTotal
ProFlu+ AssayPositive34a40a74Sensitivity 89.5% (75.9% - 95.8%) 95% CI
Negative4b748752Specificity 94.9% (93.2% - 96.2%) 95% CI
Total38788826

8 Thirty-four (34) samples positive for RSV by sequence analysis, 3 samples negative for RSV by sequence analysis, and 3 samples unavailable for sequence analysis.

ر One (1) sample positive for RSV by sequence analysis and 3 samples negative for RSV by sequence analysis.

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Results from Retrospective Study

Influenza A Comparison Results

ProFlu+ AssayReference MethodComments
PositiveNegativeTotal
Positive52a7Sensitivity 100% (56.6% - 100%) 95% CI
Negative05353Specificity 96.4% (87.7% - 99.0%) 95% CI
Total55560

ª One (1) samples positive for Influenza A by sequence analysis and 1 sample negative for Influenza A by sequence analysis

Influenza B Comparison Results

Reference Method
PositiveNegativeTotalComments
ProFlu+ AssayPositive17017Sensitivity 89.5% (68.6% - 97.1%) 95% CI
Negative2a4143Specificity 100% (91.4% - 100%) 95% CI
Total194160

Two (2) samples positive for Influenza B by sequence analysis.

RSV Comparison Results

Reference Method
PositiveNegativeTotal
ProFlu+AssayPositive231a24Sensitivity 100% (85.7% - 100%) 95% CI
Negative03636Specificity 97.3% (86.2% - 99.5%) 95% CI
Total233760

a One sample positive for RSV by sequence analysis.

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Reproducibility

The reproducibility of the ProFlu+ Assay was evaluated at 3 laboratory sites. Reproducibility was assessed using a panel of 10 simulated samples that included medium and low (near the assay limit of detection) Influenza A, Influenza B, or RSV positive and negative samples. Panels and controls were tested at each site by 2 operators for 5 days (10 samples and 5 controls X 2 operators X 5 days X 3 sites = 450). The overall percent agreement for the ProFlu+ Assay was 98%.

PanelMember IDSite 1Site 2Site 3TotalAgreement withexpectedresult (%)95%ConfidenceInterval
AgreementwithexpectedresultAVECT%CVAgreementwithexpectedresultAVECT%CVAgreementwithexpectedresultAVECT%CV
Negative (2PanelMembers)20/2030.53.2%20/2031.27.1%19*/2032.22.4%59/60(98%)91% - 100%
Influenza ALow Positive10/1036.03.3%9/1036.43.9%7/1037.85.3%26/30(87%)70% - 95%
Influenza AMediumPositive10/1032.61.4%10/1033.44.0%10/10332.5%30/30(100%)89% - 100%
Influenza BLow Positive10/1032.71.4%10/1032.61.4%10/1032.21.9%30/30(100%)89% - 100%
Influenza BMediumPositive10/1030.51.3%10/1030.10.7%10/1029.70.8%30/30(100%)89% - 100%
RSV A Lowpositive8/1030.18.3%8/1032.56.2%8/1030.76.8%24/30(80%)63% - 90%
RSV Amediumpositive10/1029.53.0%10/1029.53.0%10/1029.22.7%30/30(100%)89% - 100%
RSV B lowpositive10/1031.93.5%10/1032.35.5%10/1031.85.1%30/30(100%)89% - 100%
RSV Bmediumpositive10/1029.51.9%10/1029.54.0%10/1028.74.2%30/30(100%)89% - 100%
Influenza ARNA Control10/1033.51.6%10/1032.94.2%10/1034.40.9%30/30(100%)89% - 100%
Influenza BRNA Control10/1032.81.4%10/1032.13.1%10/1033.81.3%30/30(100%)89% - 100%
RSV A RNAControl10/1033.71.8%10/1032.33.1%10/1034.81.5%30/30(100%)89% - 100%
RSV B RNAControl10/1032.11.6%10/1031.94.3%10/1035.22.5%30/30(100%)89% - 100%
NegativeControl10/1028.94.0%10/1029.65.2%10/1030.21.4%30/30(100%)89% - 100%
TotalAgreementAll148/150 (99%)147/150 (98%)144/150 (96%)439/450(98%)96% - 99%
  • 1 negative sample Unresolved (IC = FAIL). C- values for Influenza A, Influenza B and RSV were negative, however.

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DEPARTMENT OF HEALTH & HUMAN SERVICES

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Food and Drug Administration 2098 Gaither Road Rockville MD 20850

FDA CDRH DMC

4 2008 JAN

Received

Re: K073029

Waukesha. WI 53186

Prodesse, Inc.

Karen Harrington, Ph.D.

Manager, Clinical Affairs

W229 N1870 Westwood Dr.

Trade/Device Name: ProFluTM Plus Regulation Number: 21 CFR 866.3980 Regulation Name: Respiratory viral panel multiplex nucleic acid assay Regulatory Class: Class II Product Code: OCC Dated: October 25, 2007 Received: October 26, 2007

Dear Dr. Harrington:

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).

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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 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,

Sally attaym

Sally A. Hojvat, M.Sc., Ph.D. Director Division of Microbiology Devices 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):

12073029

Device Name: ProFlu+ Assay

Indication For Use:

The ProFlu+™ Assay is a multiplex Real Time RT-PCR in vitro diagnostic test for the rapid and qualitative detection and discrimination of Influenza A Virus, Influenza B Virus, and Respiratory Syncytial Virus (RSV) nucleic acids isolated and purified from nasopharyngeal (NP) swab specimens obtained from symptomatic patients. This test is intended for use to aid in the differential diagnosis of Influenza A, Influenza B and RSV viral infections in humans and is not intended to detect Influenza C.

A negative test is presumptive and it is recommended these results be confirmed by cell culture. Negative results do not preclude influenza or RSV virus infection and should not be used as the sole basis for treatment or other management decisions.

Performance characteristics for Influenza A Virus were established when Influenza A/H3 and A/H1 were the predominant Influenza A viruses in circulation. When other Influenza A viruses are emerging, performance characteristics may vary.

If infections with a novel Influenza A virus are suspected based on current clinical and epidemiological screening criteria recommended by public health authorities, specimens should be collected with appropriate infection control precautions for novel virulent Influenza viruses and sent to state or local health department for testing. Viral culture should not be attempted in these cases unless a BSL 3+ facility is available to receive and culture specimens.

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

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)

Ule Schef
Division Sign-Off

Office of In Vitro Diagnostic Device Evaluation and Safety

(1)(k) 2073029

Page 1 of 1

§ 866.3980 Respiratory viral panel multiplex nucleic acid assay.

(a)
Identification. A respiratory viral panel multiplex nucleic acid assay is a qualitative in vitro diagnostic device intended to simultaneously detect and identify multiple viral nucleic acids extracted from human respiratory specimens or viral culture. The detection and identification of a specific viral nucleic acid from individuals exhibiting signs and symptoms of respiratory infection aids in the diagnosis of respiratory viral infection when used in conjunction with other clinical and laboratory findings. The device is intended for detection and identification of a combination of the following viruses:(1) Influenza A and Influenza B;
(2) Influenza A subtype H1 and Influenza A subtype H3;
(3) Respiratory Syncytial Virus subtype A and Respiratory Syncytial Virus subtype B;
(4) Parainfluenza 1, Parainfluenza 2, and Parainfluenza 3 virus;
(5) Human Metapneumovirus;
(6) Rhinovirus; and
(7) Adenovirus.
(b)
Classification. Class II (special controls). The special controls are:(1) FDA's guidance document entitled “Class II Special Controls Guidance Document: Respiratory Viral Panel Multiplex Nucleic Acid Assay;”
(2) For a device that detects and identifies Human Metapneumovirus, FDA's guidance document entitled “Class II Special Controls Guidance Document: Testing for Human Metapneumovirus (hMPV) Using Nucleic Acid Assays;” and
(3) For a device that detects and differentiates Influenza A subtype H1 and subtype H3, FDA's guidance document entitled “Class II Special Controls Guidance Document: Testing for Detection and Differentiation of Influenza A Virus Subtypes Using Multiplex Nucleic Acid Assays.” See § 866.1(e) for the availability of these guidance documents.