K Number
K080273
Device Name
AB-TROL AND PRIVATE LABEL GLUCOSE CONTROL SOLUTION
Date Cleared
2008-08-08

(189 days)

Product Code
Regulation Number
862.1660
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
For in vitro diagnostic use (i.e. for external use only) by healthcare professionals and in the home by people with diabetes mellitus to assess the performance of the BREEZE 2 Blood Glucose Monitor.
Device Description
The FDTX Glucose Control Solution consists of a viscosity-adjusted, aqueous liquid control solution containing a known quantity of glucose. The product is packaged in plastic dropper tipped bottles for easy application of the control solutions to the test strips and a red coloration to aid the user to visually confirm application of the control. The product is non-hazardous and contains no human or animal derived materials.
More Information

No
The device description and performance studies focus on the chemical composition and stability of a glucose control solution, with no mention of AI or ML technologies.

No
The device is a control solution used to assess the performance of a blood glucose monitor, not to treat a condition.

No
This device is a control solution used to assess the performance of a blood glucose monitor, not to diagnose a medical condition itself.

No

The device description clearly states it is a liquid control solution packaged in plastic bottles, indicating it is a physical product, not software.

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

Here's why:

  • Intended Use: The "Intended Use / Indications for Use" section explicitly states "For in vitro diagnostic use".
  • Device Description: The description details a "control solution containing a known quantity of glucose" used to "assess the performance of the BREEZE 2 Blood Glucose Monitor". This aligns with the definition of an IVD, which is used to examine specimens derived from the human body to provide information for diagnostic purposes. In this case, the control solution is used to verify the accuracy of a device that tests blood glucose levels (a specimen derived from the human body).

N/A

Intended Use / Indications for Use

For in vitro diagnostic use (i.e. for external use only) by healthcare professionals and in the home by people with diabetes mellitus to assess the performance of the BREEZE 2 Blood Glucose Monitor.

Product codes

75 JJX, JJX

Device Description

The FDTX Glucose Control Solution consists of a viscosity-adjusted, aqueous liquid control solution containing a known quantity of glucose. The product is packaged in plastic dropper tipped bottles for easy application of the control solutions to the test strips and a red coloration to aid the user to visually confirm application of the control. The product is non-hazardous and contains no human or animal derived materials.

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

healthcare professionals and in the home by people with diabetes mellitus

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)

Tests were performed to verify specific performance characteristics:

    1. Stability
    1. Open Vial
    1. Test precision
      Conclusion: Comparison of the performance characteristics, formulation and intended use support the claim of substantial equivalence.

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

Not Found

Predicate Device(s)

K062347, K060426

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

K080273

5. 510(k) Summary

AUG - 8 2008

Introduction:According to the requirements of 21 CFR 807.92, the following information provides sufficient detail to understand the basis for a determination of substantial equivalence.
Submitter:Fujirebio Diagnostics Texas Inc.
940 Crossroads Blvd
Seguin, TX 78155
(830) 372-1391 ex. 210
Establishment Registration Number: 1643621
Contact Person:John C. Gormley
Device Name:FDTX Glucose Control Solution
Common Name:Single Analyte Control Solution, All Types (Assayed and Unassayed)
Classification Name:Quality Control Material (assayed and unassayed).
Classification:Class I per 21 CFR 862.1660
Product Code:75 JJX
Panel:Chemistry
Predicate Devices:Name:Bayer Ascensia BREEZE 2 Normal ControlManufacturer:Bayer Healthcare, LLC.510(k) No.:K062347Name:Liberty Normal Glucose Control SolutionManufacturer:Liberty Healthcare Group510(k) No.:K060426Name:Bayer Ascensia BREEZE 2 Normal ControlManufacturer:Bayer Healthcare, LLC.510(k) No.:K062347Name:Liberty Normal Glucose Control SolutionManufacturer:Liberty Healthcare Group510(k) No.:K060426
Name:Bayer Ascensia BREEZE 2 Normal Control
Manufacturer:Bayer Healthcare, LLC.
510(k) No.:K062347
Name:Liberty Normal Glucose Control Solution
Manufacturer:Liberty Healthcare Group
510(k) No.:K060426
Device Description:The FDTX Glucose Control Solution consists of a viscosity-adjusted, aqueous liquid control solution containing a known quantity of glucose. The product is packaged in plastic dropper tipped bottles for easy application of the control solutions to the test strips and a red coloration to aid the user to visually confirm application of the control. The product is non-

:

1

hazardous and contains no human or animal derived materials.

The FDTX Glucose Control Solution is intended for in Intended Use: vitro diagnostic use (i.e. for external use only) by healthcare professionals and in the home by people with diabetes mellitus to assess the performance of Bayer Ascensia BREEZE 2 Blood Glucose Monitor.

Comparison to Predicate Device:

| Characteristic/

AspectPredicate Device No. 1Predicate Device No. 2New Product
NameAscensia BREEZE 2
Control NormalLiberty Glucose Normal
Control SolutionFDTX Glucose Control
Solution
510(k), DateK062347, 11/21/2006K060426, 3/09/2006K080273
Number of
Levels111
AnalyteGlucoseGlucoseGlucose
Target (mg/dL)100100100
Target Range
(mg/dL)85 - 130113 - 17085 - 130
ContainerPlastic bottle with
dropper-tipPlastic bottle with
dropper-tipPlastic bottle with
dropper-tip
Fill Volume2.5 mL3.6 mL3.6 mL
ColorBlueRedRed
MatrixBlue solution
containing a measured
amount of glucose.Buffered aqueous
solution of D-Glucose, a
viscosity modifier,
preservatives, and other
non-reactive ingredientsBuffered aqueous
solution of D-Glucose, a
viscosity modifier,
preservatives, and other
non-reactive ingredients
Indications for
UseFor use as quality
control check to verify
that the BREEZE 2
meter and test strips
are working properly.To check the
performance of the Bayer
Ascensia DEX 2/DEX
and BREEZE Blood
Glucose Monitors.To check the
performance of the Bayer
Ascensia BREEZE 2 Blood
Glucose Monitor.
Target
PopulationProfessional and home
useProfessional and home
useProfessional and home
use

2

Performance Studies: Tests were performed to verify specific performance characteristics:

    1. Stability
    1. Open Vial
    1. Test precision

Conclusion: Comparison of the performance characteristics, formulation and intended use support the claim of substantial equivalence.

3

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo features a stylized eagle with three stripes representing the department's mission. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" is arranged around the eagle in a circular fashion.

Public Health Service

Food and Drug Administration 2098 Gaither Road Rockville MD 20850

Fujirebio Diagnostics Texas, Inc c/o Mr. John Gormley, Director of Quality & Regulatory Affairs 940 Crossroads Boulevard Seguin, TX 78155

AUG - 8 2008

Re: K080273 Trade/Device Name: FDTX Glucose Control Solution Regulation Number: 21 CFR 862.1660 Regulation Name: Quality Control Material (assayed and unassayed) Regulatory Class: Class I , reserved Product Code: JJX Dated: June 17, 2008 Received: June 17, 2008

Dear Mr. Gormley:

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 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

5

Indications for Use Statement 4.

510(k) Number (if known): K080273

FDTX Glucose Control Solution Device Name:

Indications for Use:

For in vitro diagnostic use (i.e. for external use only) by healthcare professionals and in the home by people with diabetes mellitus to assess the performance of the BREEZE 2 Blood Glucose Monitor.

Prescription Use (21 CFR Part 801 Subpart D) AND/OR

Over-The-Counter Use X (21 CFR Part 807 Subpart C)

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of In Vitro Diagnostic Devices (OIVD)

Division Sign-Off Office of In Vitro Diagnostic Device Evaluation and Safety

510(k) K080273