K Number
K090964
Manufacturer
Date Cleared
2009-12-16

(254 days)

Product Code
Regulation Number
866.2660
Reference & Predicate Devices
N/A
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The BinaxNOW® Staphylococcus aureus Test is a qualitative, in vitro immunochromatographic assay for the presumptive identification of Staphylococcus aureus. The test is performed directly on blood culture samples positive for Gram-positive cocci in clusters. The BinaxNOW® Staphylococcus aureus Test is not intended to diagnose Staphylococcus aureus nor to guide or monitor treatment for Staphylococcus aureus infections. Subculturing positive blood cultures is necessary to recover organisms for susceptibility testing and/or differentiation of mixed growth.

Device Description

The BinaxNOW" Staphylococcus aureus Test is a rapid immunochromatographic membrane assay that uses highly sensitive polyclonal antibodies to detect a Staphylococcus aureus specific protein directly from blood cultures which have been identified as being positive for Gram-positive cocci in clusters. These antibodies and a control antibody are immobilized onto a test strip as two distinct lines and combined with other reagents/pads. This test strip is mounted inside a cardboard, book-shaped hinged test device. Specimens are aliquots from blood cultures which have been identified as positive for Gram-positive cocci in clusters. After the sample is prepared, it is added to the sample pad at the top of the test strip and the device is closed. Results are read at 10 minutes.

AI/ML Overview

Here's a summary of the acceptance criteria and the study details for the BinaxNOW® Staphylococcus aureus Test, based on the provided text:

1. Table of Acceptance Criteria and Reported Device Performance

Acceptance CriteriaReported Device Performance
Clinical Performance
Positive Agreement (Sensitivity)98.8% (95% C.I.: 93.6 - 99.8%)
Negative Agreement (Specificity)100.0% (95% C.I.: 98.4% - 100.0%)
Analytical Sensitivity (Limit of Detection)5.42 x 10^8 cells/mL (96% detection at this concentration)
Analytical ReactivityDetected 54 known pathogenic Staphylococcus aureus strains.
Analytical Specificity (Cross-Reactivity)No false positives with a panel of coagulase-negative Staphylococcus strains, yeasts, and numerous non-staphylococcal strains.
Interfering SubstancesNo false results with 20 potentially interfering substances (anti-inflammatory drugs, antibiotics, endogenous blood components, anticoagulant).
Reproducibility98% (588/600) agreement with expected test results across multiple sites, days, runs, and operators.

2. Sample Size Used for the Test Set and the Data Provenance

  • Sample Size (Clinical Performance Study): 325 blood culture samples.
  • Data Provenance: Retrospective and/or prospective (not explicitly stated if combined or separate, but clinical performance was "established in a multicenter clinical study conducted in 2008-09"). The data originated from three geographically-diverse hospital laboratories within the US.

3. Number of Experts Used to Establish the Ground Truth for the Test Set and the Qualifications of Those Experts

  • The document states that the BinaxNOW® Staphylococcus aureus Test performance was compared "to standard methods used routinely by the testing laboratories." It does not specify the number of experts or their qualifications for establishing the ground truth, but implies it was based on established laboratory protocols and potentially expert interpretation where applicable for "standard methods." The reference method essentially serves as the "ground truth."

4. Adjudication Method for the Test Set

  • The document does not describe a specific adjudication method (like 2+1 or 3+1). The comparison was made against "standard methods used routinely by the testing laboratories," suggesting that the results from these standard methods were taken as the truth without further expert adjudication beyond the routine lab procedures.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study was Done, If So, What was the Effect Size of How Much Human Readers Improve with AI vs Without AI Assistance

  • No, a multi-reader multi-case (MRMC) comparative effectiveness study was not done. This device is an in vitro diagnostic (IVD) assay, not an AI-assisted diagnostic tool for human readers. Its performance is evaluated independently or against a reference method.

6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) was Done

  • Yes, the clinical performance study evaluated the standalone performance of the BinaxNOW® Staphylococcus aureus Test. It's an immunochromatographic assay that provides a direct result, not an aid to a human reader. Its results were compared directly to the reference method without human interpretation as part of the device's output.

7. The Type of Ground Truth Used

  • The ground truth for the clinical performance study was established using "standard methods used routinely by the testing laboratories." For an IVD like this, this typically refers to recognized microbiological culture and identification techniques, which are considered the gold standard for bacterial identification.

8. The Sample Size for the Training Set

  • The document does not explicitly mention a "training set" in the context of device development or clinical trials. This is common for rapid immunochromatographic assays, where development involves analytical studies (reactivity, specificity, sensitivity) and then validation in clinical samples. The "training set" concept is more pertinent to machine learning algorithms.

9. How the Ground Truth for the Training Set Was Established

  • As a "training set" is not explicitly mentioned for this type of device, the method for establishing its ground truth is not applicable or described in the provided text. The analytical studies (reactivity, specificity) used well-characterized bacterial strains (e.g., ATCC, NARSA strains) for which the identity was already known, serving a similar function to establishing "ground truth" for those specific analytical evaluations.

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2090964

510(k) SUMMARY

This summary of 510(k) safety and effectiveness information is being submitted in accordance with the requirements of SMDA 1990 and 21 CFR 807.92.

The assigned 510(k) number is 090964.

SUBMITTER

Binax, Inc. 10 Southgate Road Scarborough, Maine 04074 (207) 730-5733 (Office) (207) 730-5717 (FAX) Establishment Registration Number: 1221359

CONTACT PERSON

Suzanne Vogel suzanne.vogel@invmed.com (email)

DATE PREPARED

December 12, 2009

TRADE NAME BinaxNOW® Staphylococcus aureus Test

COMMON NAME

BinaxNOW® Staphylococcus aureus Test, BinaxNOW® Staphylococcus aureus, BinaxNOW® S. aureus, Binax NOW® Staphylococcus aureus Test, Binax NOW® Staphylococcus aureus, Binax NOW® S. aureus, NOW® Staphylococcus aureus Test. NOW® Staphylococcus aureus, NOW® S. aureus

CLASSIFICATION NAME

Microorganism differentiation and identification device (JWX) (per 21 CFR 866.2660)

PREDICATE DEVICE

S. aureus PNA FISHTM (AdvanDx) K#060099

DEVICE DESCRIPTION

The BinaxNOW" Staphylococcus aureus Test is a rapid immunochromatographic membrane assay that uses highly sensitive polyclonal antibodies to detect a Staphylococcus aureus specific protein directly from blood cultures which have been identified as being positive for Gram-positive cocci in clusters. These antibodies and a control antibody are immobilized onto a test strip as two distinct lines and combined with other reagents/pads. This test strip is mounted inside a cardboard, book-shaped hinged test device.

Specimens are aliquots from blood cultures which have been identified as positive for Gram-positive cocci in clusters. After the sample is prepared, it is added to the sample pad at the top of the test strip and the device is closed. Results are read at 10 minutes.

BinaxNOW® Staphylococcus aureus Test Confidential 510(k) Notification K090964 Rev. 12/09/09

Page 1 of 6

DEC 1 6 2009

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INTENDED USE

The BinaxNOW® Staphylococcus aureus Test is a qualitative, in vitro immunochromatographic assay for the presumptive identification of Staphylococcus aureus. The test is performed directly on blood culture samples positive for Gram-positive cocci in clusters. The BinaxNOW® Staphylococcus aureus Test is not intended to diagnose Staphylococcus aureus nor to guide or monitor treatment for Staphylococcus aureus infections. Subculturing positive blood cultures is necessary to recover organisms for susceptibility testing and/or differentiation of mixed growth.

TECHNOLOGICAL CHARACTERISTICS

The BinaxNOW® Staphylococcus aureus Test is a rapid immunochromatographic membrane assay that uses highly sensitive polyclonal antibodies to detect a Staphylococcus aureus specific protein directly from blood cultures bottles positive for Gram-positive cocci in clusters.

PERFORMANCE SUMMARY

Clinical Performance

The clinical performance of the BinaxNOW® Staphylococcus aureus Test was established in a multicenter clinical study conducted in 2008-09 at three geographically-diverse hospital laboratories within the US.

A total of 325 blood culture samples with Gram-positive cocci in clusters were evaluated at the three sites in the BinaxNOW® Staphylococcus aureus Test and compared to standard methods used routinely by the testing laboratories. The BinaxNOW® Staphylococcus aureus Test identified 98.8% of the specimens positive for Staphylococcus aureus and 100.0% of the specimens negative for Staphylococcus aureus relative to the reference method.

Reference Method
BinaxNOW®Staphylococcus aureusTestPositiveNegative
Positive840
Negative1240
95% C.I.
Positive Agreement:98.8%(93.6 - 99.8%)
Negative Agreement:100.0%(98.4% - 100.0%)

BinaxNOW® Staphylococcus aureus Test Compared to Reference Method

Expected Values

BinaxNOW® Staphylococcus aureus Test 510(k) Notification K090964 Rev. 12/09/09

Confidential

Page 2 of 6

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In the external clinical evaluation of BinaxNOW® Staphylococcus aureus Test, the overall expected rate of S. aureus in blood culture was 26.2% (85/325), and among the three site populations the expected positive rate ranged from 16.9% to 41.5%.

Analytical Reactivity

The 54 human pathogenic Network on Antimicrobial Resistance in Staphylococcus aureus (NARSA) and American Type Culture Collection (ATCC) Staphylococcus aureus strains listed below tested positive in the BinaxNOW® test.

Staphylococcus aureus strains
BacteriumBacterium
Staphylococcus aureus ATCC 13150Staphylococcus aureus NRS172
Staphylococcus aureus ATCC 11632Staphylococcus aureus NRS241
Staphylococcus aureus ATCC 14776Staphylococcus aureus NRS245
Staphylococcus aureus ATCC 14458Staphylococcus aureus NRS248
Staphylococcus aureus ATCC 6517Staphylococcus aureus NRS249
Staphylococcus aureus ATCC 29737Staphylococcus aureus NRS164
Staphylococcus aureus ATCC 29213Staphylococcus aureus NRS165
Staphylococcus aureus ATCC 49476Staphylococcus aureus NRS166
Staphylococcus aureus ATCC 33592Staphylococcus aureus NRS167
Staphylococcus aureus ATCC BAA38Staphylococcus aureus NRS168
Staphylococcus aureus ATCC 14775Staphylococcus aureus NRS169
Staphylococcus aureus ATCC BAA43Staphylococcus aureus NRS170
Staphylococcus aureus LaffertyStaphylococcus aureus NRS171
Staphylococcus aureus ATCC 6538PStaphylococcus aureus NRS173
Staphylococcus aureus ATCC BAA1026Staphylococcus aureus NRS174
Staphylococcus aureus ATCC BAA977Staphylococcus aureus NRS175
Staphylococcus aureus ATCC BAA39Staphylococcus aureus NRS176
Staphylococcus aureus ATCC51153Staphylococcus aureus NRS177
Staphylococcus aureus ATCC 700789Staphylococcus aureus NRS382 (USA100)
Staphylococcus aureus ATCC BAA41Staphylococcus aureus NRS383 (USA200)
Staphylococcus aureus ATCC 33591Staphylococcus aureus NRS384 (USA300)
Staphylococcus aureus ATCC BAA44Staphylococcus aureus NRS123 (USA400)
Staphylococcus aureus ATCC 700698Staphylococcus aureus NRS385 (USA500)
Staphylococcus aureus ATCC 43300Staphylococcus aureus NRS22 (USA600)
Staphylococcus aureus ATCC 700699Staphylococcus aureus NRS386 (USA700)
Staphylococcus aureus NRS193Staphylococcus aureus NRS387 (USA800)
Staphylococcus aureus NRS194Staphylococcus aureus NRS192

Stanhulococcus aureus strains

Analytical Specificity (Cross-Reactivity)

To determine the analytical specificity of the BinaxNOW® Staphylococcus aureus Test, coagulasenegative Staphylococcus strains, yeasts and non-staphylococcal strains were tested in the BinaxNOW® Test. All strains in the tables below tested negative.

Bacterium
Staphylococcus auricularis ATCC 33753

BinaxNOW® Staphylococcus aureus Test Confidential 510(k) Notification K090964 Rev. 12/09/09

Page 3 of 6

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Staphylococcus capitis ATCC 35661
Staphylococcus caprae ATCC 51548
Staphylococcus cohnii ATCC 29972
Staphylococcus delphini ATCC 49171
Staphylococcus epidermidis ATCC 700579
Staphylococcus haemolyticus ATCC 29970
Staphylococcus hominis ATCC 27844
Staphylococcus hyicus ATCC 11249
Staphylococcus intermedius ATCC 29663
Staphylococcus kloosii ATCC 43959
Staphylococcus lentus ATCC 700403
Staphylococcus lugdunensis ATCC 43809
Staphylococcus lutrae ATCC 700373
Staphylococcus pasteuri ATCC 51128
Staphylococcus pseudintermedius ATCC 49444
Staphylococcus pulvereri ATCC 51698
Staphylococcus saprophyticus ATCC 35552
Staphylococcus schleiferi ATCC 43808
Staphylococcus sciuri ATCC 49575
Staphylococcus stimulans ATCC 27851
Staphylococcus vitulinus ATCC 51162
Staphylococcus warneri ATCC 49454
Staphylococcus xylosus ATCC 49148

Non- Staphylococcal Strains

Non-Staphylococcal Strains
BacteriumBacterium
Acinetobacter calcoaceticus ATCC 51432Pasteurella multocida ATCC 51687
Aerococcus urinae ATCC 700306Pediococcus acidilactici ATCC 12697
Aerococcus viridans ATCC 10400Peptostreptococcus anaerobius ATCC 27337
Aeromonas hydrophilia ATCC 35654Planococcus citreus ATCC 14404
Bacillus cereus ATCC 11778Proteus mirabilis ATCC 7002
Bacillus subtilis ATCC 6633Proteus vulgaris ATCC 33420
Bacteroides fragilis ATCC 23745Providencia stuartii ATCC 49809
Beta strep group F ATCC 12392Pseudomonas aeruginosa ATCC 15442
Burkholdaria cepacia ATCC 25416-TPseudomonas fluorescens ATCC 49271
Citrobacter freundii ATCC 8090Pseudomonas putida ATCC 49128
Clostridium septicum ATCC 12646Rhodococcus equi ATCC 10146
Clostridium sordelli ATCC 9714Salmonella adelaide ATCC 10718
Corynebacterium amycolatum ATCC 49368Serratia marcescens ATCC 13880
Corynebacterium diphtheriae ATCC 13812Stenotrophomonas maltophilia ATCC 13637-T
Corynebacterium glutamicum ATCC 13869Stomatococcus (Rothia mucilaginosa) ATCC 25296
Corynebacterium jeikeium ATCC 43734Stomatococcus (Rothia mucilaginosa) ATCC 49040
Corynebacterium pseudodiptheriticum ATCC 10700-T
Stomatococcus (Rothia mucilaginosa) ATCC 49041
Corynebacterium urealyticum ATCC 43042Stomatococcus (Rothia mucilaginosa) ATCC 49042
Corynebacterium xerosus ATCC 7711Streptococcus agalactiae (Beta Strep Group B) ATCC 13813

BinaxNOW® Staphylococcus aureus Test
510(k) Notification K090964
Rev. 12/09/09

.

Confidential

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Enterobacter aerogenes ATCC 35029Streptococcus anginosis (milleri) ATCC 33397
Enterobacter cloacae ATCC 49141Streptococcus dysgalactiae (Group C) ATCC 12388
Enterococcus avium ATCC 49462Streptococcus dysgalactiae (Group G) ATCC 12394
Enterococcus casseliflavus ATCC 12817Streptococcus intermedius (milleri) ATCC 27355
Enterococcus durans ATCC 49135Streptococcus mitis ATCC 49456
Enterococcus faecalis ATCC 49474Streptococcus mutans ATCC 25175
Enterococcus faecium ATCC 12952Streptococcus pasteurans (bovis) ATCC 49133
Enterococcus gallinarum ATCC 49608Streptococcus pneumoniae ATCC 33400
Enterococcus hirae ATCC 10541Streptococcus pneumoniae ATCC 39938
Enterococcus mundtii ATCC 43187Streptococcus pneumoniae ATCC 49136
Enterococcus raffinosus ATCC 49464Streptococcus pneumoniae ATCC 49619
Escherichia coli ATCC 10798Streptococcus pneumoniae ATCC 51937
Gemella spp. bergeri ATCC 700627Streptococcus pneumoniae ATCC 51938
Haemophilus influenzae ATCC 49247Streptococcus pneumoniae ATCC 6301
Klebsiella oxytoca ATCC 49131Streptococcus pneumoniae ATCC SSI-1
Klebsiella pneumoniae ATCC 49472Streptococcus pneumoniae ATCC SSI-10A
Lactobacillus casei ATCC 393Streptococcus pneumoniae ATCC SSI-14
Lactococcus spp.garvieae ATCC 49157Streptococcus pneumoniae ATCC SSI-7F
Leuconostoc mesenteriodes ATCC 10877Streptococcus pyogenes, group A ATCC 12384
Listeria monocytogenes ATCC 19115Streptococcus salivarius ATCC 13419
Macrococcus caseolyticus (formerly Staph cohnii subsp. cohnii) ATCC 35662Streptococcus salivarius ATCC 13419
Micrococcus luteus ATCC 27141Yeasts
Moraxella catarrhalis ATCC 25238Candida albicans ATCC 60193
Morganella morganii ATCC 25830-TCandida glabrata ATCC 66032
Neisseria meningitides (serogroup A) ATCC 13077Candida tropicalis ATCC 750
Neisseria sicca ATCC 9913

Interfering Substances:

None of the 20 potentially interfering substances listed below produced false results in the BinaxNOW® Staphylococcus aureus test.

. . . . . .

.

Anti-InflammatoryDrugsTest ConcentrationEndogenous Blood ComponentsTest Concentration
Acetaminophen$1324 \mu mol/L$Hemoglobin2 g/L
Acetylsalicyclic acid3.62 mmol/LTriglyceride sera37 mmol/L
Ibuprofen$2425 \mu mol/L$Conjugated bilirubin$342 \mu mol/L$
AntibioticsTest ConcentrationUnconjugated bilirubin$342 \mu mol/L$
Amoxicillin$206 \mu mol/L$$\gamma$ - globulin120g/L
Cephalexin$337 \mu mol/L$Anti-coagulantTest Concentration
Chloramphenicol$155 \mu mol/L$Sodium Polyanetholesulfonate (SPS)1%
Ciprofloxacin$30.2 \mu mol/L$
Erythromycin$81.6 \mu mol/L$
Gentamicin$21 \mu mol/L$

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Tetracycline34 $ $\mu$ $ mol/L
Sulfisoxazole1.12 mmol/L
Sulfamethoxazole1.58 mmol/L
Trimethoprim138 $ $\mu$ $ mol/L
Vancomycin69 $ $\mu$ $ mol/L

Analytical Sensitivity:

The analytical limit of detection of the BinaxNOW® Staphylococcus aureus Test is 5.42 x 10° cells/mL.

BacterialConcentrationcells/mLNumberDetected%Detection
$2.71 \times 10^9$26/26100
$5.42 \times 10^8$25/2696
$1.14 \times 10^8$15/2675
$7.07 \times 10^7$10/2650

Reproducibility Study:

A study of the BinaxNOW® Staphylococcus aureus Test was conducted at 3 separate sites using panels of blind coded specimens containing negative and positive samples. Participants tested each sample twice on 5 different days. There was 98% (588/600) agreement with expected test results, with no significant differences within run (replicates tested by one operator), between run (5 different days), between sites (3 sites), or between operators (6 operators).

Signed Angela Drysdale Clinical Affairs Binax, Inc.

Date

BinaxNOW® Staphylococcus aureus Test 510(k) Notification K090964 Rev. 12/09/09

Confidential

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Image /page/6/Picture/0 description: The image shows the seal of the Department of Health & Human Services - USA. The seal is circular and contains an image of an eagle. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" are arranged around the top of the circle. The eagle is facing to the right.

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

DEC 1 6 2009

Binax, Inc. c/o Ms. Suzanne Vogel Clinical Affairs Inverness Medical 10 Southgate Road Scarborough, ME 04074

Re: K090964

Trade Name: BinaxNow® Staphylococcus Aureus Test Regulation Number: 21 CFR §866.2660 Regulation Name: Microorganism differentiation and identification device Regulatory Class: Class I Product Codes: JWX Dated: October 23, 2009 Received: October 30, 2009

Dear Ms. Vogel:

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

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Enclosure

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).

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) 276-0484. 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 (301) 443-6597 or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html

Sincerely yours,

Souza Atomo

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

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ATTACHMENT 14: INDICATIONS FOR USE FORM

510(k) Number: 090964

Device Name: BinaxNOW® Staphylococcus aureus Test

Indications for Use:

The BinaxNOW® Staphylococcus aureus Test is a qualitative, in vitro immunochromatographic assay for the presumptive identification of Staphylococcus aureus. The test is performed directly on blood culture samples positive for Gram-positive cocci in clusters. The BinaxNOW Staphylococcus aureus Test is not intended to diagnose Staphylococcus aureus nor to guide or monitor treatment for Staphylococcus aureus infections. Subculturing positive blood cultures is necessary to recover organisms for susceptibility testing and/or differentiation of mixed growth.

Prescription Use V (Part 21 CFR 801 Subpart D)

AND/OR

Over-The-Counter Use (21 CFR 801 Subpart C)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Freddie U. Rocke

Division Sign-Off Office of In Vitro Diagnostic Device Evaluation and Safety 510(k) K090964

BinaxNOW® Staphylococcus aureus Test Confidential 510(k) Notification K090964 Rev. 12/09/09

§ 866.2660 Microorganism differentiation and identification device.

(a)
Identification. A microorganism differentiation and identification device is a device intended for medical purposes that consists of one or more components, such as differential culture media, biochemical reagents, and paper discs or paper strips impregnated with test reagents, that are usually contained in individual compartments and used to differentiate and identify selected microorganisms. The device aids in the diagnosis of disease.(b)
Classification. Class I (general controls). The device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to § 866.9.