K Number
K102908
Device Name
NOFACT IX
Date Cleared
2011-12-19

(444 days)

Product Code
Regulation Number
864.7290
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
NoFact IX Deficient Plasma is a human plasma immunodepleted of Factor IX and intended for the quantitative determination of Factor IX activity in citrated plasma from patients suspected of FIX deficiency. FIX activity is based on the activated partial thromboplastin time. For in vitro diagnostic use.
Device Description
NoFact IX Deficient Plasma is a human plasma immunodepleted of Factor IX and intended for the quantitative determination of Factor IX activity in citrated plasma from patients suspected of FIX deficiency. FIX activity is based on the activated partial thromboplast time. For in vitro diagnostic use.
More Information

No
The 510(k) summary describes an in vitro diagnostic reagent (deficient plasma) used in a standard coagulation assay (activated partial thromboplastin time) for measuring Factor IX activity. There is no mention of AI, ML, image processing, or any computational analysis beyond standard statistical methods for performance evaluation.

No
Explanation: The device is intended for in vitro diagnostic use to determine Factor IX activity, not for treating a condition.

Yes

Explanation: The "Intended Use/Indications for Use" explicitly states that the device is "intended for the quantitative determination of Factor IX activity in citrated plasma from patients suspected of FIX deficiency" and is "For in vitro diagnostic use." The "Device Description" reiterates this, confirming its role in diagnosing FIX deficiency by measuring Factor IX activity.

No

The device is a biological reagent (human plasma) used in an in vitro diagnostic test, not a software program.

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

Here's why:

  • Explicit Statement: The "Intended Use / Indications for Use" and "Device Description" sections both clearly state: "For in vitro diagnostic use."
  • Intended Use: The device is intended for the "quantitative determination of Factor IX activity in citrated plasma from patients suspected of FIX deficiency." This is a diagnostic test performed on a biological sample (plasma) outside of the body (in vitro).
  • Method: The determination of FIX activity is based on the activated partial thromboplastin time, which is a common laboratory test.

These points definitively classify the device as an In Vitro Diagnostic.

N/A

Intended Use / Indications for Use

NoFact IX Deficient Plasma is a human plasma immunodepleted of Factor IX and intended for the quantitative determination of Factor IX activity in citrated plasma from patients suspected of FIX deficiency. FIX activity is based on the activated partial thromboplastin time. For in vitro diagnostic use.

Product codes

GJT

Device Description

NoFact IX Deficient Plasma is a human plasma immunodepleted of Factor IX and intended for the quantitative determination of Factor IX activity in citrated plasma from patients suspected of FIX deficiency. FIX activity is based on the activated partial thromboplastin time. For in vitro diagnostic use.

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

NoFact IX Deficient Plasma was compared to the predicate STA IX Deficient plasma using the Stago PTT-A FIX assay on the STA Compact. Plasma samples were assayed in parallel with the Stago PTT-A assay using the STA IX deficient plasma ("Stago results"), and also with the same assay but where the NoFact IX deficient plasma was substituted for the STA IX deficient plasma ("NoFact results"). A total of two hundred and thirty-three plasma samples in three laboratories were analyzed. The linear regression equation of this comparison was: y = 0.858* x + 5.73, with a coefficient of determination of 0.915.

The Stago PTT-A IX assay was evaluated for precision with three separate lots of NoFact IX ﻥ Deficient Plasma according to the CLSI guideline EP5-A2 "Evaluation of Precision Performance of Quantitative Measurement Methods; Approved Guideline-20d Edition".

Key results:

  • Regression analysis:
    • All Labs (N=233): Slope = 0.858, Intercept = 5.729, r2 = 0.915, r = 0.956
    • Site 1 (N=100): Slope = 0.785, Intercept = 6.168, r2 = 0.977, r = 0.988
    • Site 2 (N=80): Slope = 0.923, Intercept = 5.328, r2 = 0.907, r = 0.988
    • Site 3 (N=53): Slope = 0.817, Intercept = 11.206, r2 = 0.830, r = 0.911
  • Precision:
    • System N (Normal Control Plasma) N=240, Mean FIX activity = 109%: % CV, Within-run (S-r) = 5.1%, % CV, Lot-to-Lot (S-lot) = 1.1%, % CV, Within-Device (S-device) = 7.2%
    • System P (Abnormal Control Plasma) N=240, Mean FIX activity = 43%: % CV, Within-run (S-r) = 4.6%, % CV, Lot-to-Lot (S-lot) = 2.9%, % CV, Within-Device (S-device) = 7.7%
    • Low FIX pooled patient plasma N=120, Mean FIX activity = 14%: % CV, Within-run (S-r) = 5.7%, % CV, Lot-to-Lot (S-lot) = 2.2%, % CV, Within-Device (S-device) = 7.8%

Key Metrics

  • Coefficient of determination (r2)
  • r (correlation coefficient)
  • Slope
  • Intercept
  • Percent Coefficient of Variation (%CV)

Predicate Device(s)

K933432

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 864.7290 Factor deficiency test.

(a)
Identification. A factor deficiency test is a device used to diagnose specific coagulation defects, to monitor certain types of therapy, to detect coagulation inhibitors, and to detect a carrier state (a person carrying both a recessive gene for a coagulation factor deficiency such as hemophilia and the corresponding normal gene).(b)
Classification. Class II (performance standards).

0

510(k) Summary

This summary of 510(k) safety and effectiveness is being submitted in accordance with the requirements of the Safe Medical Device Act of 1990 and 21 CFR 807.92.

The assigned 510(k) number is: K102908.

1) Applicant Name and Address

Applicant:r2 Diagnostics, Inc.
Address:1801 Commerce Drive
South Bend, IN 46628
Contact Person:Marc D. Goldford
Phone #:574-288-4377
Fax #:574-288-2272
Email:marc@r2diagnostics.com
Date of Preparation:15 November 2010

2) Device Name(s)

Trade Name:NoFact IX
Classification Name:Plasma, Factor Deficient (21CFR 864.7290, Product Code GJT)

3) Predicate Device(s)

Stago IX Deficient Plasma (K933432)

4) Device Description(s)

NoFact IX Deficient Plasma is a human plasma immunodepleted of Factor IX and intended for the quantitative determination of Factor IX activity in citrated plasma from patients suspected of FIX deficiency. FIX activity is based on the activated partial thromboplastin time. For in vitro diagnostic use.

5) Intended Use(s)

NoFact IX Deficient Plasma is a human plasma immunodepleted of Factor IX and intended for the quantitative determination of Factor IX activity in citrated plasma from patients suspected of FIX deficiency. FIX activity is based on the activated partial thromboplastin time. For in vitro diagnostic use.

1

6) Technological Characteristic Summary

  • Comparison of the submitted kit and the predicate kit is summarized in the table below: a.
Comparison of submitted device NoFact IX to
predicate device STA Deficient IX
Similarities
ItemSubmitted DevicePredicate Device
Intended useNoFact IX Deficient Plasma is a
human plasma immunodepleted
of Factor IX and intended for
the quantitative determination
of Factor IX activity in citrated
plasma from patients suspected
of FIX deficiency. FIX activity
is based on the activated partial
thromboplastin time. For in
vitro diagnostic use.STA Deficient IX is an
immunodepleted human
plasma intended for use in tests
for the determination of factor
IX activity in plasma by
analyzers of the STA line
suitable with this reagent.
Constituent materialCitrated human plasma
immunodepleted of Factor IX.Citrated human plasma
immunodepleted of Factor IX.
Measurement principleDiluted patient sample is mixed
with factor IX deficient plasma
and then tested with an APTT.
In these conditions the clotting
time of the mixture is
dependent on the
concentration of FIX in the
patient sample.Diluted patient sample is mixed
with factor IX deficient plasma
and then tested with an APTT.
In these conditions the clotting
time of the mixture is
dependent on the
concentration of FIX in the
patient sample.
FormatLyophilized plasmaLyophilized plasma
Analyte being testedFactor IX activityFactor IX activity
Differences
ItemSubmitted DevicePredicate Device
Reconstituted Stability2-8C: 8 hr
RT: 4 hr2-8C: not listed
RT: not listed
On-board STA Compact: 4 hrs
  • b. NoFact IX Deficient Plasma was compared to the predicate STA IX Deficient plasma using the Stago PTT-A FIX assay on the STA Compact. Plasma samples were assayed in parallel with the Stago PTT-A assay using the STA IX deficient plasma ("Stago results"), and also with the same assay but where the NoFact IX deficient plasma was substituted for the STA IX deficient plasma ("NoFact results"). A total of two hundred and thirty-three plasma samples in three laboratories

2

were analyzed. The linear regression equation of this comparison was: y = 0.858* x + 5.73, with a coefficient of determination of 0.915.

All LabsSite 1Site 2Site 3
N=233N=100N=80N=53
Slope0.8580.7850.9230.817
Intercept5.7296.1685.32811.206
r20.9150.9770.9070.830
r0.9560.9880.9880.911

The regression statistics by site were:

  • The Stago PTT-A IX assay was evaluated for precision with three separate lots of NoFact IX ﻥ Deficient Plasma according to the CLSI guideline EP5-A2 "Evaluation of Precision Performance of Quantitative Measurement Methods; Approved Guideline-20d Edition":

| Plasma | Mean FIX
activity, % | % CV, Within-run
(S-r) | % CV, Lot-to-Lot
(S-lot) | % CV, Within-
Device (S-
device) |
|---------------------------------------------------|-------------------------|---------------------------|-----------------------------|----------------------------------------|
| System N
(Normal Control
Plasma)
N=240 | 109% | 5.1% | 1.1% | 7.2% |
| System P
(Abnormal Control
Plasma)
N=240 | 43% | 4.6% | 2.9% | 7.7% |
| Low FIX pooled patient
plasma
N=120 | 14% | 5.7% | 2.2% | 7.8% |

NoFact IX Deficient Plasma provides acceptable precision.

NoFact IX Deficient Plasma is substantially equivalent to Stago IX Deficient Plasma.

3

Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized depiction of an eagle or bird-like figure with outstretched wings, rendered in a simple, flowing line. The bird is positioned to the right of a circular text element that reads "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" in a sans-serif font.

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

r2 Diagnostics, Inc. c/o Mr. Marc D. Goldford Director, Research and Development 1801 Commerce Dr. South Bend, IN 46628

DEC 1 9 2011

Re: K102908

Trade/Device Name: NoFact IX Deficient Plasma Regulation Number: 21 CFR 864.7290 Regulation Name: Factor Deficiency Test Regulatory Class: Class II Product Code: GJT Dated: December 7, 2011 Received: December 8, 2011

Dear Mr. Goldford:

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

4

Page 2 - Mr. Marc D. Goldford

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 advice for your device on our labeling regulation (21 CFR Parts 801 and 809), 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 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) 796-7100 or at its Internet address http://www.fda.gov/cdrl/industry/support/index.html.

Sincerely yours,

Reena Philip

roh

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

5

Indications for Use

510(k) Number (if known): K 102908

Device Name: NoFact IX Deficient Plasma

Indications For Use: NoFact IX Deficient Plasma is a human plasma immunodepleted of Factor IX and intended for the quantitative determination of Factor IX activity in citrated plasma from patients suspected of FIX deficiency. FIX activity is based on the activated partial thromboplastin time. For in vitro diagnostic use.

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)

Division Sign-Off

Office of In Vitro Diagnostic Device Evaluation and Safety

510(k) K102908