K Number
K092169
Device Name
ELECSYS PROBNP II CALCHECK 5
Manufacturer
Date Cleared
2009-12-16

(148 days)

Product Code
Regulation Number
862.1660
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The Elecsys proBNP II CalCheck 5 is an assayed control for use in calibration verification and for use in the verification of the assay range established by the Elecsys proBNP II reagent on the indicated Elecsys and cobas e immunoassay analyzers.
Device Description
The Elecsys proBNP II CalCheck 5 is a lyophilized product consisting of NT-proBNP (1-76) amide, human serum and a potassium phosphate buffered matrix. During manufacture, the analytes are spiked into the matrix at the desired concentration levels.
More Information

Not Found

No
The document describes a calibration control for an immunoassay analyzer, which is a chemical reagent product, not a software or imaging device that would typically incorporate AI/ML. The "Mentions AI, DNN, or ML" section explicitly states "Not Found".

No
The device is described as an assayed control for calibration verification and assay range verification of a reagent, and it contains analytes such as NT-proBNP. It does not exert a therapeutic effect on a patient.

No
This device is described as an "assayed control" for calibration verification and assay range verification of a reagent, not a device used to diagnose a patient's condition.

No

The device description clearly states it is a "lyophilized product consisting of NT-proBNP (1-76) amide, human serum and a potassium phosphate buffered matrix," indicating it is a physical substance, not software.

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

Here's why:

  • Intended Use: The intended use explicitly states it's for "calibration verification" and "verification of the assay range" for an IVD reagent (Elecsys proBNP II reagent) on immunoassay analyzers. These are activities performed in vitro (outside the body) to ensure the accuracy and reliability of diagnostic tests.
  • Device Description: The description details a "lyophilized product consisting of NT-proBNP (1-76) amide, human serum and a potassium phosphate buffered matrix." This is a prepared substance designed to be used in a laboratory setting with diagnostic equipment.
  • Predicate Device: The mention of a predicate device (K080147; Elecsys proBNP II CalCheck) which is also an IVD control, further supports its classification as an IVD.

While the document doesn't mention image processing, AI, or patient information, the core function of this device is to support the accuracy of an in vitro diagnostic test.

N/A

Intended Use / Indications for Use

The Elecsys proBNP II CalCheck 5 is an assayed control for use in calibration verification and for use in the verification of the assay range established by the Elecsys proBNP II reagent on the indicated Elecsys and cobas e immunoassay analyzers.

Product codes

JJX

Device Description

The Elecsys proBNP II CalCheck 5 is a lyophilized product consisting of NT-proBNP (1-76) amide, human serum and a potassium phosphate buffered matrix. During manufacture, the analytes are spiked into the matrix at the desired concentration levels.

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

Not Found

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

The Elecsys proBNP II CalCheck 5 was evaluated for value assignment and stability.

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

Not Found

Predicate Device(s)

K080147

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc)

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

K092169

DEC 162009

ﺴﻴﺔ ﺇﻳﺮﺍﻧﻴﺔ

510(k) Summary

DEC 16 2009

IntroductionAccording 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 name, address, contactRoche Diagnostics
9115 Hague Road
Indianapolis, IN 46250
317-521-3208
Contact Person: Kelly French
Date Prepared: July 15, 2009
Device NameProprietary name: Elecsys proBNP II CalCheck 5
Common name: proBNP II CalCheck 5
Classification name: Single (specified) analyte controls (assayed and unassayed)
Predicate deviceThe Elecsys proBNP II CalCheck 5 is substantially equivalent to other products in commercial distribution intended for similar use. We claim equivalency to the currently marketed Elecsys proBNP II CalCheck (K080147).
Device DescriptionThe Elecsys proBNP II CalCheck 5 is a lyophilized product consisting of NT-proBNP (1-76) amide, human serum and a potassium phosphate buffered matrix. During manufacture, the analytes are spiked into the matrix at the desired concentration levels.
Intended useThe Elecsys proBNP II CalCheck 5 is an assayed control for use in calibration verification and for use in the verification of the assay range established by the Elecsys proBNP II reagent on the indicated Elecsys and cobas e immunoassay analyzers.

Continued on next pageContinued on next page

t

1

510(k) Summary, Continued

The table below compares Elecsys proBNP II CalCheck 5 with the predicate Comparison device, Elecsys proBNP II Calcheck (K080147). Table

| Characteristic | Elecsys proBNP II CalCheck
(K080147) | Elecsys proBNP II CalCheck 5 |
|----------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Intended Use | For use in the verification of the
calibration established by the
Elecsys proBNP II reagent on the
Elecsys and cobas e immunoassay
analyzers. | The Elecsys proBNP II CalCheck
5 is an assayed control for use in
calibration verification and for use
in the verification of the assay
range established by the Elecsys
proBNP II reagent on the indicated
Elecsys and cobas e immunoassay
analyzers. |
| Levels | Three | Five |
| Format | Lyophilized | Same |
| Handling | Reconstitute with exactly 1.0 mL
distilled or deionized water and
allow standing closed for 15
minutes, then mixing gently. | Same |
| Stability | Unopened:
· Store at 2-8ºC until expiration
date
Reconstituted:
· 20 - 25 °C : 4 hrs | Same |
| Matrix | Human serum | Same |
| Buffer | Potassium phosphate buffer | Same |

Performance Characteristics The Elecsys proBNP II CalCheck 5 was evaluated for value assignment and stability.

2

Image /page/2/Picture/0 description: The image shows a logo for the U.S. Department of Health and Human Services. The logo consists of a stylized abstract symbol resembling an eagle or bird in flight, composed of three curved lines. The symbol is positioned to the right of the text, which reads "DEPARTMENT OF HUMAN SERVICES - USA" arranged in a circular fashion around the symbol. The text and symbol are both in black and are set against a white background.

DEPARTMENT OF HEALTH & HUMAN SERVICES

Roche Diagnostics Roche Professional Diagnostics c/o Ms. Kelly French Regulatory Affairs Consultant 9115 Hague Road P.O. Box 50416 Indianapolis, IN 46250-0416

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

DEC 1 6 2009

K092169 Re:

Trade Name: Elecsys proBNP II CalCheck 5 Regulation Number: 21 CFR §862.1660 Regulation Name: Quality Control Material (assayed and unassayed) Regulatory Class: Class I, reserved Product Codes: JJX Dated: December 1, 2009 Received: December 2, 2009

Dear Ms. French:

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); 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 (OS) regulation (21 CFR Part 820).

3

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 vours.

CA

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

4

Indications for Use

510(k) Number (if known): K092169

Device Name: Elecsys proBNP II CalCheck 5

Indications For Use:

The Elecsys proBNP II CalCheck 5 is an assayed control for use in calibration verification and for use in the verification of the assay range established by the Elecsys proBNP II reagent on the indicated Elecsys and cobas e immunoassay analyzers.

Prescription Use X (Part 21 CFR 801 Subpart D)

:

AND/OR

Over-The-Counter Use (21 CFR 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)

Carol Benan
Division Sign-Off

Office of In Vitro Diagnostic Device Evaluation and Safety Koszlo 510(k)

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