K Number
K101234
Device Name
VENTANA ANTI-HELICOBACTER PYLORI (SP48) RABBIT MONOCLONAL PRIMARY ANTIBODY
Date Cleared
2011-08-25

(479 days)

Product Code
Regulation Number
866.3110
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
VENTANA anti-Helicobacter pylori (SP48) Rabbit Monoclonal Primary Antibody (VENTANA anti-H. pylori (SP48)) is designed to qualitatively detect the presence of Helicobacter pylori in formalin-fixed, paraffin-embedded gastric biopsy tissue via light microscopy. Immunohistochemical staining with this antibody product may aid in the diagnosis of Helicobacter pylori infection. This product should be interpreted by a qualified pathologist in conjunction with histological examination, relevant clinical information and proper controls. This antibody is intended for in vitro diagnostic (IVD) use.
Device Description
IHC in vitro diagnostic antibody directed against H. pylori organisms and visualized though the application of either of two standard chromogenic secondary detection kits to locate and bind primary antibodies bound to tissue samples. Use of either detection system results in a dark brown colored precipitate at the site of specific antibody binding.
More Information

Not Found

No
The device description and performance studies focus on an immunohistochemical staining method and its comparison to a traditional staining method, with no mention of AI/ML algorithms, image processing for automated analysis, or training/test sets for model development.

No.
This device is an in vitro diagnostic antibody used to detect the presence of Helicobacter pylori; it does not treat or prevent a disease.

Yes
The "Intended Use / Indications for Use" states that the product "may aid in the diagnosis of Helicobacter pylori infection" and is "intended for in vitro diagnostic (IVD) use."

No

The device is an in vitro diagnostic antibody, which is a biological reagent, not a software program.

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

The document explicitly states in the "Intended Use / Indications for Use" section:

"This antibody is intended for in vitro diagnostic (IVD) use."

And in the "Device Description" section:

"IHC in vitro diagnostic antibody directed against H. pylori organisms..."

N/A

Intended Use / Indications for Use

VENTANA anti-Helicobacter pylori (SP48) Rabbit Monoclonal Primary Antibody (VENTANA anti-H. pylori (SP48)) is designed to qualitatively detect the presence of Helicobacter pylori in formalin-fixed, paraffin-embedded gastric biopsy tissue via light microscopy. Immunohistochemical staining with this antibody product may aid in the diagnosis of Helicobacter pylori infection. This product should be interpreted by a qualified pathologist in conjunction with histological examination, relevant clinical information and proper controls.

This antibody is intended for in vitro diagnostic (IVD) use.

Product codes (comma separated list FDA assigned to the subject device)

LYR, OWF

Device Description

IHC in vitro diagnostic antibody directed against H. pylori organisms and visualized though the application of either of two standard chromogenic secondary detection kits to locate and bind primary antibodies bound to tissue samples. Use of either detection system results in a dark brown colored precipitate at the site of specific antibody binding.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Light microscopy

Anatomical Site

gastric biopsy tissue

Indicated Patient Age Range

Not Found

Intended User / Care Setting

qualified pathologist

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

A Method Comparison study was conducted to demonstrate the percent positive and negative agreement rates for the comparison of VENTANA anti- H. pylori (SP48) Rabbit Monoclonal Primary Antibody with Ventana Giemsa Staining Kit for determining the presence of H. pylori at three independent clinical sites. A total of 294 cases were considered evaluable by both assay methods and were therefore included in the analyses of agreement rates between VENTANA anti- H. pylori (SP48) and Ventana Giemsa Staining Kit.

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

Non-clinical performance testing has been conducted to demonstrate performance characteristics of VENTANA anti-Helicobacter pylori (SP48). Results of tissue- specificity and precision testing are noted in the product package insert.

A Method Comparison study was conducted to demonstrate the percent positive and negative agreement rates for the comparison of VENTANA anti- H. pylori (SP48) Rabbit Monoclonal Primary Antibody with Ventana Giemsa Staining Kit for determining the presence of H. pylori at three independent clinical sites. A total of 294 cases were considered evaluable by both assay methods and were therefore included in the analyses of agreement rates between VENTANA anti- H. pylori (SP48) and Ventana Giemsa Staining Kit. Pooled data from all sites demonstrated positive agreement in COMPARISON OF VENTANA ANTI-HELICOBACTER PYLORI (SP48) RABBIT MONOCLONAL PRIMARY ANTIBODY TO PREDICATE DEVICE, PYLO-PLUS, K052708

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

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K052708

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

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

§ 866.3110

Campylobacter fetus serological reagents.(a)
Identification. Campylobacter fetus serological reagents are devices that consist of antisera conjugated with a fluorescent dye used to identifyCampylobacter fetus from clinical specimens or cultured isolates derived from clinical specimens. The identification aids in the diagnosis of diseases caused by this bacterium and provides epidemiological information on these diseases.Campylobacter fetus is a frequent cause of abortion in sheep and cattle and is sometimes responsible for endocarditis (inflammation of certain membranes of the heart) and enteritis (inflammation of the intestines) in humans.(b)
Classification. Class I (general controls).

0

K101234

510(k) Summary

AUG 25 2011

Submitter: Ventana Medical Systems, Inc. Judy Howe Contact: (original): 30-Apr-2010 Date Prepared Date Revised: 26-Jul-2011

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: K101234

Device NameVENTANA anti-Helicobacter pylori (SP48) Rabbit Monoclonal Primary Antibody
Common name:IHC laboratory test for detection of Helicobacter pylori
Classification:21CFR866.3110, Immunology and Microbiology Devices
Product Code:LYR
Device DescriptionIHC in vitro diagnostic antibody directed against H. pylori organisms and visualized
though the application of either of two standard chromogenic secondary detection kits
to locate and bind primary antibodies bound to tissue samples. Use of either detection
system results in a dark brown colored precipitate at the site of specific antibody
binding.
Intended UseVENTANA anti-Helicobacter pylori (SP48) Rabbit Monoclonal Primary Antibody is
designed to qualitatively detect the presence of Helicobacter pylori in formalin-fixed,
paraffin-embedded gastric biopsy tissue via light microscopy. Immunohistochemical
staining with this antibody product may aid in the diagnosis of Helicobacter pylori
infection. This product should be interpreted by a qualified pathologist in conjunction
with histological examination, relevant clinical information and proper controls.
This antibody is intended for in vitro diagnostic (IVD) use.
Summary of the new devicesVENTANA anti-Helicobacter pylori (SP48) is substantially equivalent to a commercially
available predicate device.
Ventana has evaluated the performance of VENTANA anti-Helicobacter pylori (SP48)
by comparing it with Ventana Giemsa Staining Kit and H. pylori diagnosis obtained
from enrollment pathology reports for the detection of H. pylori infection in gastric
biopsy tissue for patients. The Ventana Giemsa Staining Kit is a qualitative histologic
stain to differentiate leukocytes in bone marrow and other hematopoietic tissue (lymph
nodes) in formalin fixed, paraffin embedded tissue and can also be used to
demonstrate some microorganisms, including H. pylori .
Geimsa stains all enteric bacteria blue while VENTANA anti-Helicobacter pylori (SP48)
detects the whole H. pylori organism in situ . The characteristic helical shape and
localization of the organisms within the crypts of the mucosa assist the clinician in
making an accurate diagnosis of infection.
Non-clinical performance dataNon-clinical performance testing has been conducted to demonstrate performance
characteristics of VENTANA anti-Helicobacter pylori (SP48). Results of tissue-
specificity and precision testing are noted in the product package insert.
Clinical performance dataA Method Comparison study was conducted to demonstrate the percent positive and
negative agreement rates for the comparison of VENTANA anti- H. pylori (SP48)
Rabbit Monoclonal Primary Antibody with Ventana Giemsa Staining Kit for determining
the presence of H. pylori at three independent clinical sites. A total of 294 cases were
considered evaluable by both assay methods and were therefore included in the
analyses of agreement rates between VENTANA anti- H. pylori (SP48) and Ventana
Giemsa Staining Kit. Pooled data from all sites demonstrated positive agreement in
COMPARISON OF VENTANA ANTI-HELICOBACTER PYLORI (SP48) RABBIT MONOCLONAL PRIMARY ANTIBODY
TO PREDICATE DEVICE, PYLO-PLUS, K052708
PARAMETERPREDICATE DEVICEPROPOSED DEVICE
PROPRIETARY
NAMEPYLO-PLUS, K052708VENTANA ANTI-HELICOBACTER PYLORI (SP48)
RABBIT MONOCLONAL PRIMARY ANTIBODY
FDA
CLASSIFICATIONCLASS I, NON-EXEMPTCLASS I, NON-EXEMPT
INTENDED USEPYLO-PLUS IS INTENDED FOR
QUALITATIVE DETECTION OF THE
UREASE ENZYME IN GASTRIC MUCOSAL
BIOPSY SPECIMENS AND FOR THE
PRESUMPTIVE DETERMINATION OF
HELICOBACTER PYLORI IN
SYMPTOMATIC ADULT PATIENTS.VENTANA MEDICAL SYSTEMS' VENTANA ANTI-
HELICOBACTER PYLORI (SP48) RABBIT
MONOCLONAL PRIMARY ANTIBODY IS DESIGNED
TO QUALITATIVELY DETECT THE PRESENCE OF
HELICOBACTER PYLORI IN FORMALIN FIXED,
PARAFFIN EMBEDDED GASTRIC BIOPSY TISSUE VIA
LIGHT MICROSCOPY. IMMUNOHISTOCHEMICAL
STAINING WITH THIS ANTIBODY PRODUCT MAY AID
IN THE DIAGNOSIS OF HELICOBACTER PYLORI
INFECTION. THIS PRODUCT SHOULD BE
INTERPRETED BY A QUALIFIED PATHOLOGIST IN
CONJUNCTION WITH HISTOLOGICAL EXAMINATION,
RELEVANT CLINICAL INFORMATION AND PROPER
CONTROLS.
THIS ANTIBODY IS INTENDED FOR IN VITRO
DIAGNOSTIC (IVD) USE.
SAMPLEGASTRIC MUCOSAL BIOPSY
SPECIMENSFORMALIN-FIXED, PARAFFIN-EMBEDDED GASTRIC
BIOPSY TISSUE
ASSAY METHODSEROLOGICAL REAGENTIHC WITH SECONDARY DETECTION
TARGETUREASE ENZYMEWHOLE ORGANISM
ASSAY FORMATMANUALAUTOMATED
DETECTION
SYSTEMDIRECTINDIRECT
VISUALIZATIONINTERPRETATION BY COLORIMETRICINTERPRETATION BY LIGHT MICROSCOPY
PARAMETERPREDICATE DEVICEPROPOSED DEVICE
PROPRIETARY
NAMEPylo-Plus, K052708VENTANA ANTI-HELICOBACTER PYLORI (SP48)
RABBIT MONOCLONAL PRIMARY ANTIBODY
MAGENTA
INTENDED USE
POPULATIONGASTRIC BIOPSY FROM PATIENTS
SUSPECTED OF HAVING H. PYLORIGASTRIC BIOPSY FROM PATIENTS SUSPECTED OF
HAVING H. PYLORI
QUALITATIVE OR
QUANTITATIVEQUALITATIVEQUALITATIVE
CONCLUSIONVENTANA anti-Helicobacter PYLORI (SP48) IS SUBSTANTIALLY EQUIVALENT TO PYLO-
PLUS IN RELEVANT CHARACTERISTICS AND THE PERFORMANCE DIFFERENCES WILL NOT
ADVERSELY AFFECT SAFETY AND EFFICACY.

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Image /page/3/Picture/0 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. Inside the circle is a stylized image of an eagle with its wings spread.

DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service

Food and Drug Administration 10903 New Hampshire Avenue Silver Spring, MD 20993

VENTENA Medical Systems, Inc. c/o Ms. Judy Howe Regulatory Affairs Specialist 1910 Innovation Park Drive Tucson, AZ 85755

AUG 25 2011

K 101つなん Re:

K101234
Trade/Device Name:VENTANA anti-Helicobacter pylori (SP48) Rabbit Monoclonal
Primary Antibody
Regulation Number:21CFR §866.3110
Regulation Name:Campylobacter fetus serological reagents
Regulatory Class:Class I
Product Code:OWF
Dated:August 10, 2011
Received:August 15, 2011

Dear Ms. Howe:

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 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 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); 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

4

Page 2 - Ms. Judy Howe

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 advice for your device on our labeling regulation (21 CFR Part 801 and 809), please contact the Office of In Vitro Diagnostic Device Evaluation and Safety at (01) 796-5450. Also, please note the regulation entitled, "Misbranding by reference to paremarket notification" (21 CFR Part 807.97). 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 no (800) 638-2041 or (301) 796-7100 or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.

Sincerely yours,

Freddie M. Poole

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

Enclosure

5

Indications for Use

510(k) Number: K101234

Device Name: VENTANA anti-Helicobacter pylori (SP48) Rabbit Monoclonal Primary Antibody

Indications for Use:

VENTANA anti-Helicobacter pylori (SP48) Rabbit Monoclonal Primary Antibody (VENTANA anti-H. pylori (SP48)) is designed to qualitatively detect the presence of Helicobacter pylori in formalin-fixed, paraffin-embedded gastric biopsy tissue via light microscopy. Immunohistochemical staining with this antibody product may aid in the diagnosis of Helicobacter pylori infection. This product should be interpreted by a qualified pathologist in conjunction with histological examination, relevant clinical information and proper controls.

This antibody is intended for in vitro diagnostic (IVD) use.

Prescription Use __________AND/OR Over-the Counter Use (21 CFR 801 Subpart C) (Part 21 CFR 801 Subpart D)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Freddie Tu. Pool

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

510(k) k 101237

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