K Number
K082965
Device Name
DS-A BLOOD GLUCOSE MONITORING SYSTEM
Date Cleared
2009-12-07

(430 days)

Product Code
Regulation Number
862.1345
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The A-CHECK DS-A Blood Glucose Monitoring System is used with DS-A Test Strips and 3-level Controls for the measurement of glucose in fresh capillary whole blood from the finger. Testing is done outside the body ( in vitro diagnostic use). It is indicated for use at home ( over the counter [OTC] ) by person with diabetes, or in clinical setting by health care professionals, as an aid to monitor the effectiveness of diabetes control. These are not intended for the diagnosis of or screening for diabetes mellitus, and are not intended for use on neonates. The DS-A Test Strips are intended for the quantitative measurement of glucose in fresh capillary whole blood samples drawn from the fingertips. DS-A Test Strips must be used with the A-CHECK DS-A Blood Glucose Monitoring System. Testing is done outside the body (In Vitro diagnostic use). Thev are indicated for use at home (over the counter [OTC]) by persons with diabetes, or in clinical settings by healthcare professionals, as an aid to monitor the effectiveness of diabetes control. These are not intended for the diagnosis of or screening for diabetes mellitus, and are not intended for use on neonates. The Alliance Blood Glucose 3 levels Control Solution are for use with the A-CHECK DS-A Blood Glucose Monitoring System and DS-A Test Strips as a quality control check to verify the accuracy of blood glucose test results.
Device Description
Based on an electrochemical biosensor technology and the principle of capillary action, DS-A Blood Glucose Monitoring System only needs a small amount of blood. Capillary action at the end of the test strip draws the blood into the action chamber and your blood glucose result is precisely and is displayed in 6 seconds. The Draw-In blood glucose test strip is designed to provide an easy, accurate method for the determination of blood glucose in fingertip capillary whole blood. When the blood is applied to the edge of reaction zone, the blood is drawn into the reaction chamber and will display a reading on the meter. Only a small amount of blood is needed. The test strip for the quantitative measurement of blood glucose in the range is from 20-600 mg/dL (1.1-33.3 mmol/L).
More Information

ACCU-CHEK Aviva System (K043474)

YSI 2300

No
The device description and performance studies focus on electrochemical biosensor technology and standard analytical performance metrics, with no mention of AI or ML.

No
A therapeutic device is one that treats or prevents a disease. This device is an in vitro diagnostic (IVD) tool used for monitoring glucose levels, which aids in managing diabetes but does not directly treat or prevent it.

No

This device is specifically stated as "not intended for the diagnosis of or screening for diabetes mellitus". It is used "as an aid to monitor the effectiveness of diabetes control" for individuals already diagnosed.

No

The device description explicitly mentions a "Blood Glucose Monitoring System" and "DS-A Test Strips" which are hardware components used for electrochemical biosensing and capillary action to measure glucose. The summary also details performance studies involving these physical components.

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

The Intended Use section explicitly states: "Testing is done outside the body ( in vitro diagnostic use)." This is a clear indication that the device is intended for in vitro diagnostic use.

N/A

Intended Use / Indications for Use

The A-CHECK DS-A Blood Glucose Monitoring System is used with DS-A Test Strips and 3-level Controls for the measurement of glucose in fresh capillary whole blood from the finger. Testing is done outside the body ( in vitro diagnostic use). It is indicated for use at home ( over the counter [OTC] ) by person with diabetes, or in clinical setting by health care professionals, as an aid to monitor the effectiveness of diabetes control. It is not intended for the diagnosis of or screening for diabetes mellitus, and is not intended for use on neonates.

The DS-A Test Strips are intended for the quantitative measurement of glucose in fresh capillary whole blood samples drawn from the fingertips. DS-A Test Strips must be used with the A-CHECK DS-A Blood Glucose Monitoring System. Testing is done outside the body (In Vitro diagnostic use). They are indicated for use at home (over the counter [OTC]) by persons with diabetes, or in clinical settings by healthcare professionals, as an aid to monitor the effectiveness of diabetes control. They are not intended for the diagnosis of or screening for diabetes mellitus, and is not intended for use on neonates.

The Alliance Blood Glucose 3 levels Control Solution are for use with the A-CHECK DS-A Blood Glucose Monitoring System and DS-A Test Strips as a quality control check to verify the accuracy of blood glucose test results.

Product codes

NBW, CGA, NBW, JJX

Device Description

Based on an electrochemical biosensor technology and the principle of capillary action, DS-A Blood Glucose Monitoring System only needs a small amount of blood. Capillary action at the end of the test strip draws the blood into the action chamber and your blood glucose result is precisely and displayed in 6 seconds.

The Draw-In blood glucose test strip is designed to provide an easy, accurate method for the determination of blood glucose in fingertip capillary whole blood. When the blood is applied to the edge of reaction zone, the blood is drawn into the reaction chamber and will display a reading on the meter. Only a small amount of blood is needed. The test strip for the quantitative measurement of blood glucose in the range is from 20-600 mg/dL (1.1-33.3 mmol/L).

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

finger / fingertips

Indicated Patient Age Range

Not intended for use on neonates. Other age ranges not specified.

Intended User / Care Setting

Home (over the counter [OTC]) by person with diabetes, or in clinical setting by health care professionals.

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

For Home Users
A study done with 150 patients to see how well the A-Check DS-A Blood Glucose Monitoring System compared to the YSI 2300 (reference method).

Precision (Repeatability Precision)
40 tests of Draw-In series test strips were performed with each glucose concentration (40, 80, 120, 200, and 300 mg/dL) using oxygenated Heparin-venous blood.

Linearity
2 lots of Draw-In test strips were tested to assess the accuracy of the A-CHECK DS-A Blood Glucose Monitoring System by comparing to the reference method (YSI 2300) using venous whole blood concentrations between 20 and 600 mg/dL.

Accuracy
1 lot of Draw-In test strips were tested to assess the accuracy of the A-CHECK DS-A Blood Glucose Monitoring System by comparing to the reference method (YSI 2300) using whole blood concentrations. A study done with 178 patients getting samples by professionals was conducted to compare A-Check DS-A Blood Glucose Monitoring System to the YSI 2300.

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

Synopsis of Test Methods and Results:
Pre-clinical and clinical data were employed.

For Home Users:
Study with 150 patients comparing A-Check DS-A Blood Glucose Monitoring System to YSI 2300.
Results for glucose concentration :
Within ± 5 mg/dL: 16/32 (50.0%)
Within ± 10 mg/dL: 25/32 (78.1%)
Within ± 15 mg/dL: 32/32 (100%)

A-CHECK DS-A System accuracy results for glucose concentration ≥ 4.2 mmol/L :
Within ± 5%: 102/146 (69.9%)
Within ± 10%: 124/146 (84.9%)
Within ± 15%: 136/146 (93.2%)
Within ± 20%: 146/146 (100.0%)

Regression for Accuracy (Lot 1): Slope = 1.00, Intercept = 4.5mg/dL, r = 0.997, R2 = 0.993

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

Not Found (Specific metrics like Sensitivity, Specificity, PPV, NPV were not explicitly stated for device performance, rather accuracy percentages within certain glucose deviation ranges were provided.)

Predicate Device(s)

ACCU-CHEK Aviva System (K043474)

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 862.1345 Glucose test system.

(a)
Identification. A glucose test system is a device intended to measure glucose quantitatively in blood and other body fluids. Glucose measurements are used in the diagnosis and treatment of carbohydrate metabolism disorders including diabetes mellitus, neonatal hypoglycemia, and idiopathic hypoglycemia, and of pancreatic islet cell carcinoma.(b)
Classification. Class II (special controls). The device, when it is solely intended for use as a drink to test glucose tolerance, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 862.9.

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510(K) Summary of Safety and Effectiveness II. (Per 21 CFR 807.92)

2.1. General Information Establishment

Date Prepared:September 28, 2008DEC - 7 2009
Manufacturer:ALLIANCE International Co., Ltd.
Address:No.54, Ying Tao Rd. Yinge Town, Taipei County, 23942, Taiwan, ROC
Owner Number:9099902
Contact Person:Dr. Jen, Ke-MinE-mail: ceirs.jen@msa.hint.net
886-3-5208829 (Tel); 886-3-5209783 (Fax)
Address:No.58, Fu Chiun Street, Hsin Chu City, 30067, Taiwan, ROC
Device
● Proprietary Name:DS-A Blood Glucose Monitoring System
● Common Name:Blood Glucose Monitoring System
● Classification Name:SYSTEM, TEST, BLOOD GLUCOSE, OVER THE COUNTER, Class II
● Product Code:NBW

2.2. Safety and Effectiveness Information

  • . Predicate Device: Claim of Substantial Equivalence (SE) is made to ACCU-CHEK Aviva System (K043474).
  • Based on an electrochemical biosensor technology ● Device Description: and the principle of capillary action, DS-A Blood Glucose Monitoring System only needs a small amount of blood. Capillary action at the end of the test strip draws the blood into the action chamber and your blood glucose result is precisely and displayed in 6 seconds.

The Draw-In blood glucose test strip is designed to provide an easy, accurate method for the determination of blood glucose in fingertip capillary whole blood. When the blood is applied to the edge of reaction zone, the blood is drawn into the reaction chamber and will display a reading on the meter. Only a small amount of blood is needed. The test strip for the quantitative measurement of blood glucose in the range is from 20-600 mg/dL (1.1-33.3 mmol/L).

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Intended Use: .

The A-CHECK DS-A Blood Glucose Monitoring System is used with DS-A Test Strips and 3-level Controls for the measurement of glucose in fresh capillary whole blood from the finger. Testing is done outside the body ( in vitro diagnostic use). It is indicated for use at home ( over the counter [OTC] ) by person with diabetes, or in clinical setting by health care professionals, as an aid to monitor the effectiveness of diabetes control. It is not intended for the diagnosis of or screening for diabetes mellitus, and is not intended for use on neonates.

The DS-A Test Strips are intended for the quantitative measurement of glucose in fresh capillary whole blood samples drawn from the fingertips. DS-A Test Strips must be used with the A-CHECK DS-A Blood Glucose Monitoring System. Testing is done outside the body (In Vitro diagnostic use). They are indicated for use at home (over the counter [OTC]) by persons with diabetes, or in clinical settings by healthcare professionals, as an aid to monitor the effectiveness of diabetes control. They are not intended for the diagnosis of or screening for diabetes mellitus, and is not intended for use on neonates.

The Alliance Blood Glucose 3 levels Control Solution are for use with the A-CHECK DS-A Blood Glucose Monitoring System and DS-A Test Strips as a quality control check to verify the accuracy of blood glucose test results.

Substantial Equivalence (SE) ●

A claim of substantial equivalence is made to ACCU-CHEK Aviva System Both of them have the same working principle and (K043474). The differences are coding method, sample volume, meter technologies. dimension, weight, HCT range, and memory data number. Besides, the subject device is intended for the quantitative measurement of glucose in fresh capillary whole blood from the finger but the predicate device can test whole blood include traditional fingertip site along with palm, forearm, upper arm, thigh, and calf. Thus the differences are due to the feature design aspects, not relating to the safety or effectiveness aspects. They are substantially equivalent.

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Differences
ItemsA-CHECK DS-A
(Alliance International )
Subject Device (K082965)Accu-Chek Aviva (Roche)
Predicate Device (K043474)
Test PrincipleGOD Electrochemical biosensor with
carbon electrodesGDH Electrochemical
Meter Weight56 g60 g
Memory Storage360 test results500 blood glucose results
Meter CodingCode CardCode Key
Operating
Temperature14 to 40 °C6 to 44 °C
Strip Storage
Temperature4 to 32 °C2 to 32 °C
LimitationsA-Check Draw-In test strips are
designed for use with fresh capillary
whole blood sample. Do Not use
serum or plasma samples.
  1. It should not be used in Intensive
    Care settings or if the patient is
    dehydrated, hypotensive, hypoxic,
    in diabetic ketoacidosis, in shock, or
    in a hyperglycemic/hyperosmolar
    state.
  2. Hematocrit: Variation in sample
    hematocrit between 30% and 55%
    has no significant effect on test
    results. Very high (above 55%) and
    very low (below 30%) hematocrit
    can cause inaccurate results.
  3. Neonates: Do not use Draw-In test
    strips to test neonates. The
    performance of this system has not
    been validated with neonatal
    samples.
  4. Blood concentration of Ascorbic
    Acid > 1.2mg/dL or Uric Acid >
    7mg/dL will cause overestimation of
    blood glucose results.
  5. Therapeutic levels of L-dopa
    (>10mg/dL) or Dopamine (>
    30mg/dL) may result in inaccurate
    (elevated) glucose readings with the
    system.
  6. Acetaminophen (
    10mg/dL or maltose > 13 mg/dL will
    cause overestimation of blood
    glucose results.
  7. Do not use during a xylose
    absorption test.
  8. Lipemic samples in excess of 4800
    mg/dL may produce elevated results.
  9. In situations of decreased peripheral
    blood flow, fingerstick blood testing
    may not be appropriate as it may not
    reflect the true physiological state.
    Examples would include, but are not
    limited to: severe dehydration caused
    by diabetic ketoacidosis or the
    hyperglycemic hyperosmolar
    nonketotic state, hypotension, shock
    severe congestive heart failure, or
    peripheral vascular disease.
  10. Blood glucose determination with
    venous blood must be performed
    within 30 minutes of ample
    collection.
  11. For best results with venous blood,
    the following
    anticoagulants/preservation is
    recommended: heparin or EDTA.
    Serum separator tubes are acceptable
    if whole blood is used immediately,
    lodoacetate or fluoride-containing
    anticoagulants are not recommended.
  12. Refrigerated samples should be |

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. Synopsis of Test Methods and Results

Pre-clinical and clinical data are employed upon submission of this 510(K) premarket notification according to the Guidance Document for In Vitro Diagnostic Test System; Guidance for Industry and FDA document provided by CDRH/ FDA.

For Home Users

The table below was based on a study done with 150 patients to see how well the A-Check DS-A Blood Glucose Monitoring System compared to the YSI 2300.

Image /page/3/Figure/4 description: This image is a scatter plot titled "Lay User". The x-axis is labeled "YSI 2300" and ranges from 0 to 450. The y-axis is labeled "DS-A Meter" and ranges from 0 to 450. The data points are clustered around a diagonal line, indicating a positive correlation between the two variables.

Results for glucose concentration

Within ± 5 mg/dLWithin ± 10 mg/dLWithin ± 15 mg/dL
16/32 (50.0%)25/32 (78.1%)32/32 (100%)

A-CHECK DS-A System accuracy results for glucose concentration≥ 4.2 mmol/L

Within ± 5%Within ± 10%Within ± 15%Within ± 20%
102/146 (69.9%)124/146 (84.9%)136/146 (93.2%)146/146 (100.0%)
LotSlopeInterceptrR2
11.004.5mg/dL0.9970.993

Y= A-CHECK DS-A Blood Glucose Meter X= YSI 2300

Keiichi Ito

Dr. Jen, Ke-Min official correspondent for ALLIANCE International Co., Ltd.

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Image /page/6/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized eagle or bird-like symbol with three curved lines forming its body and wings. The logo is encircled by the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" in a circular arrangement. The text is in all caps and appears to be in a sans-serif font.

Food and Drug Administration 10903 New Hampshire Avenue Document Mail Center - WO66-0609 Silver Spring, MD 20993-0002

Alliance International Co., Ltd. c/o Dr. Ke-Min Jen No. 58, Fu Chiun Street Hsin Chu City, 30067, Taiwan, ROC

DEC - 7 2009

Re: K082965

Trade/Device Name: DS-A Blood Glucose Monitoring System Regulation Number: 21 CFR §862.1345 Regulation Name: Glucose Test System Regulatory Class: II Product Code: CGA, NBW, JJX Dated: November 20, 2009 Received: December 01, 2009

Dear Dr. Jen:

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 class II (Special Controls), 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); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); and good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820).

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Page 2

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 (301) 796-5450. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 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 (301) 796-5760. For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

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 ( 301 ) 796-5680 or at its Internet address http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm.

Sincerely yours,

Signature

Courtney C. Harper, Ph.D. Director Division of Chemistry and Toxicology 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): (k)082965

Device Name: DS-A Blood Glucose Monitoring System

Indication For Use:

The A-CHECK DS-A Blood Glucose Monitoring System is used with DS-A Test Strips and 3-level Controls for the measurement of glucose in fresh capillary whole blood from the finger. Testing is done outside the body ( in vitro diagnostic use). It is indicated for use at home ( over the counter [OTC] ) by person with diabetes, or in clinical setting by health care professionals, as an aid to monitor the effectiveness of diabetes control. These are not intended for the diagnosis of or screening for diabetes mellitus, and are not intended for use on neonates.

The DS-A Test Strips are intended for the quantitative measurement of glucose in fresh capillary whole blood samples drawn from the fingertips. DS-A Test Strips must be used with the A-CHECK DS-A Blood Glucose Monitoring System. Testing is done outside the body (In Vitro diagnostic use). Thev are indicated for use at home (over the counter [OTC]) by persons with diabetes, or in clinical settings by healthcare professionals, as an aid to monitor the effectiveness of diabetes control. These are not intended for the diagnosis of or screening for diabetes mellitus, and are not intended for use on neonates.

The Alliance Blood Glucose 3 levels Control Solution are for use with the A-CHECK DS-A Blood Glucose Monitoring System and DS-A Test Strips as a quality control check to verify the accuracy of blood glucose test results.

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

Over the Counter Use _ V (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 (OIVD)

Carol Benson

Division Sign-Off Office of In Vitro Diagnostic Device Evaluation and Safety 510(k) (k)082965