K Number
K090137
Device Name
STAK-CHEX PLUS RETICS
Manufacturer
Date Cleared
2009-03-18

(56 days)

Product Code
Regulation Number
864.8625
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
STaK-Chex Plus Retics is an assayed whole blood control for evaluating the accuracy and precision of automated, semi-automated and manual procedures that measure blood cell parameters.
Device Description
STaK-Chex Plus Retics is a stabilized suspension of human red blood cells, a nucleated red blood cell analog, a white blood cell component consisting of human analogs and a platelet component consisting of a non-human analog in a preservative medium. The product is packaged in plastic vials containing 5ml. The closures are polypropylene screw caps with polyethylene liners. There are three different levels (low, normal and high). The vials will be packaged in a six (6) or twelve (12) welled vacuum formed "clam-shell" container with the package insert / assay sheet. The product must be stored at 2 - 10° C.
More Information

No
The device is a blood control product used for evaluating the accuracy and precision of blood cell parameter measurements, and the description focuses on its composition, packaging, storage, and stability testing, with no mention of AI or ML.

No
This device is a control for evaluating the accuracy and precision of blood cell parameter measurements, not for treating any medical condition.

No

The device is described as an "assayed whole blood control for evaluating the accuracy and precision of automated, semi-automated and manual procedures that measure blood cell parameters." It is used to test the performance of diagnostic procedures, not to diagnose a patient.

No

The device description clearly states it is a stabilized suspension of biological components (human red blood cells, analogs, etc.) in a preservative medium, packaged in vials. This is a physical control material, not software.

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

Here's why:

  • Intended Use: The intended use explicitly states that it is "an assayed whole blood control for evaluating the accuracy and precision of automated, semi-automated and manual procedures that measure blood cell parameters." This clearly indicates that the device is used in vitro (outside the body) to analyze a biological sample (whole blood) for diagnostic purposes (evaluating the performance of blood cell parameter measurements).
  • Device Description: The description details the composition of the product as a "stabilized suspension of human red blood cells, a nucleated red blood cell analog, a white blood cell component consisting of human analogs and a platelet component consisting of a non-human analog in a preservative medium." This further confirms that it is a reagent or material used in laboratory testing.
  • Performance Studies: The description of performance studies (Closed Vial Stability, Open Vial Stability, Run to Run Reproducibility, and External Site recovery of values) are typical studies conducted for IVD control materials to demonstrate their reliability and consistency in laboratory settings.
  • Predicate Device: The mention of a predicate device (K992887; STaK-Chex Plus Retics) which is also a control material for blood cell analysis strongly suggests that this device falls under the same regulatory category, which is IVD.

Therefore, based on the provided information, STaK-Chex Plus Retics is an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

STaK-Chex Plus Retics is an assayed whole blood control for evaluating the accuracy and precision of automated, semi-automated and manual procedures that measure blood cell parameters.

Product codes

GLQ

Device Description

STaK-Chex Plus Retics is a stabilized suspension of human red blood cells, a nucleated red blood cell analog, a white blood cell component consisting of human analogs and a platelet component consisting of a non-human analog in a preservative medium. The product is packaged in plastic vials containing 5ml. The closures are polypropylene screw caps with polyethylene liners. There are three different levels (low, normal and high). The vials will be packaged in a six (6) or twelve (12) welled vacuum formed "clam-shell" container with the package insert / assay sheet. The product must be stored at 2 - 10° C.

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

Four types of studies were conducted to establish performance of STaK-Chex Plus Retics. The four tests conducted were Closed Vial Stability, Open Vial Stability, Run to Run Reproducibility, and External Site recovery of values.

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

Closed Vial Stability, Open Vial Stability, Run to Run Reproducibility, and External Site recovery of values. All testing showed that STaK-Chex Plus Retics is consistently reproducible, substantially equivalent to the predicate product and stable for the shelf life claimed.

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

Not Found

Predicate Device(s)

K992887

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 864.8625 Hematology quality control mixture.

(a)
Identification. A hematology quality control mixture is a device used to ascertain the accuracy and precision of manual, semiautomated, and automated determinations of cell parameters such as white cell count (WBC), red cell count (RBC), platelet count (PLT), hemoglobin, hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC).(b)
Classification. Class II (special controls). Except when intended for use in blood components, the device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 864.9.

0

Ko90137

510(k) Summary of Safety and Effectiveness

| 510(k) Submitter: | Streck
7002 South 109th Street
Omaha, NE 68128 | MAR 1 8 2009 |
|------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------|--------------|
| | Official Correspondent: Carol Thompson, Quality Assurance Manager
(402)-537-5213 | |
| Date Prepared: | January 19, 2009 | |
| Name of Device:
Trade Name:
Common Name:
Classification Name: | STaK-Chex® Plus Retics
Assayed Hematology Control
Hematology quality control mixture (864.8625) | |
| Predicate Device: | STaK-Chex Plus Retics (K992887) Manufactured by Streck | |

Description:

STaK-Chex Plus Retics is a stabilized suspension of human red blood cells, a nucleated red blood cell analog, a white blood cell component consisting of human analogs and a platelet component consisting of a non-human analog in a preservative medium. The product is packaged in plastic vials containing 5ml. The closures are polypropylene screw caps with polyethylene liners. There are three different levels (low, normal and high). The vials will be packaged in a six (6) or twelve (12) welled vacuum formed "clam-shell" container with the package insert / assay sheet. The product must be stored at 2 - 10° C.

Intended Use:

STaK-Chex Plus Retics is an assayed whole blood control for evaluating the accuracy and precision of automated, semi-automated and manual procedures that measure blood cell parameters.

STaK-Chex Plus Retics (Predicate Product)STaK-Chex Plus Retics
Intended Use
StatementSTak-Chex Plus Retics is intended
to be used as a control for complete
blood cell count (CBC), white cell 5-
part differential, and reticulocyte
parameters on Beckman Coulter
GenS series hematology
instruments.STaK-Chex Plus Retics is an
assayed whole blood control for
evaluating the accuracy and
precision of automated, semi-
automated and manual procedures
that measure blood cell
parameters.
Open Vial Stability14 daysSame
Closed Vial Stability105 days75 days
ReagentsStabilized human and animal bloodLow Level - Stabilized human and
animal blood, plus a nucleated red
blood cell analog
Normal and High Levels same as
Predicate
Storage Conditions2 - 10°CSame

Comparison to Predicate Device:

l of 2

1

Discussion of Tests and Test Results:

Four types of studies were conducted to establish performance of STaK-Chex Plus Retics. The four tests conducted were Closed Vial Stability, Open Vial Stability, Run to Run Reproducibility, and External Site recovery of values. All testing showed that STaK-Chex Plus Retics is consistently reproducible, substantially equivalent to the predicate product and stable for the shelf life claimed.

Conclusions Drawn From Tests:

Study results show STak-Chex Plus Retics to be consistently reproducible, substantially equivalent to the products, and stable for the entire product dating. STaK-Chex Plus Retics is a safe and effective product, which fulfills its intended use when used as instructed in the product package insert.

2

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/2/Picture/1 description: The image shows the logo for the Department of Health & Human Services. The logo is a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES . USA" around the perimeter. Inside the circle is an image of an eagle with its wings spread, clutching a caduceus in its talons. The eagle is facing to the right.

Public Health Service

Food and Drug Administration 2098 Gaither Road Rockville MD 20850

MAR 1 8 2009

Streck, Inc. c/o Ms. Kerrie Oetter Quality Assurance Coordinator 7002 South 109th St. Omaha, Nebraska 68128

Re: K090137

Trade/Device Name: STaK-Chex ® Plus Retics. Regulation Number: 21 CFR 864.8625 Regulation Name: Hematology Quality Control mixture Regulatory Class: II Product Code: GLQ Dated: March 4, 2009 Received: March 10, 2009

Dear Ms. Oetter:

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 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). You may, therefore, market the device, subject to the general controls provisions of the Act. However, you are responsible to determine that the medical devices you use as components in the [kit/tray] have either been determined as substantially equivalent under the premarket notification process (Section 510(k) of the act), or were legally on the market prior to May 28, 1976, the enactment date of the Medical Device Amendments. Please note: If you purchase your device components in bulk (i.e., unfinished) and further process (e.g., sterilize) you must submit a new 510(k) before including these components in your kit/trav. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, and 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

3

Page 2 - Ms. Kerrie Oetter

limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

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, pennits your device to proceed to the market.

If you desire specific advice for your device on the labeling regulation, 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" (21 CFR Part 807.97). For question 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 many obtain other general information on your responsibilities under the Act from the Division of Small Manufactuers, 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,

ia m chan

Maria M. Chan, Ph.D. Director Division of Immunology and Hematology Devices Office of In Vitro Diagnostic Device Evaluation and Safety

Center for Devices and Radiological Health

Enclosure

4

Indication for Use

510(k) Number (if known):

Device Name: STaK-Chex Plus Retics

Indication For Use:

STaK-Chex Plus Retics is an assayed whole blood control for evaluating the accuracy and precision of automated procedures that measure blood cell parameters.

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 (OIVD)

Stephine Bautista

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

510(k) K090137