K Number
K103021
Device Name
ELEMENT PLUS BLOOD GLUCOSE MONITORING SYSTEM
Manufacturer
Date Cleared
2011-11-04

(388 days)

Product Code
Regulation Number
862.1345
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Element ™ plus Blood Glucose Monitoring System is for the quantitative measurement of glucose in capillary whole blood taken from the fingertip, ventral palm, dorsal hand, upper arm, forearm, calf and/or thigh. Element ™ plus Blood Glucose Testing System is for in vitro diagnostic use and is not to be used for the diagnosis of or screening for diabetes or for neonatal use. Element "M plus Blood Glucose Monitoring System is intended to be used by a single patient and should not be shared. The Element ™ plus Blood Glucose Monitoring System is intended for self-testing outside the body (in vitro diagnostic use) by people with diabetes at home as an aid in the management of diabetes. Alternative site Testing (ventral palm, dorsal hand, upper arm, forearm, calf and/or thigh) should be done during steady- state times when glucose is not changing rapidly. The Element Plus Test strip are for use with the Element Plus Blood Glucose Meter to quantitatively measure glucose (sugar) in capillary whole blood samples drawn from ventral palm, dorsal hand, upper arm, forearm, calf and/or thigh. This meter contains some speaking functions but has not been validated for use by the visually impaired.
Device Description
Element ™ plus Blood Glucose Monitoring System is comprised of test meter, test strip and control solutions. Element "" plus blood glucose test meter is substantially identical with the predicate device (Evolution "M: K072369). The minor difference is that Element "M plus test meter has voice function, which Evolution "" test meter does not have. The voice function can be used as an aid for the users to hear the test results, setting conditions and warning messages. This added function is intended to aid users' convenience. Element 1 1 plus blood glucose test strip is identical with the predicate device (Evolution 1M. K072369) except the cover design of the test strip. Element "1" plus glucose control solutions are also exactly same as Evolution "M control solutions.
More Information

No
The document describes a standard blood glucose monitoring system with a voice function for user convenience. There is no mention of AI or ML in the intended use, device description, or performance studies.

No.
This device is for monitoring glucose levels as "an aid in the management of diabetes," not for treating or curing the condition itself.

No

The text explicitly states: "Element ™ plus Blood Glucose Testing System is for in vitro diagnostic use and is not to be used for the diagnosis of or screening for diabetes or for neonatal use." While it's an in vitro diagnostic device, it's not intended for diagnosis of a condition but rather as an aid in management for people already diagnosed with diabetes.

No

The device description explicitly states that the system is comprised of a test meter, test strip, and control solutions, which are hardware components.

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

Here's why:

  • Explicit Statement: The "Intended Use / Indications for Use" section explicitly states: "Element ™ plus Blood Glucose Testing System is for in vitro diagnostic use..." and "...intended for self-testing outside the body (in vitro diagnostic use)..."
  • Nature of the Test: The device measures glucose in capillary whole blood, which is a biological sample taken from the body and tested in vitro (outside the body).
  • Purpose: The purpose is to aid in the management of diabetes by providing quantitative measurements of glucose, which is a diagnostic parameter.

N/A

Intended Use / Indications for Use

The Element ™ plus Blood Glucose Monitoring System is for the quantitative measurement of glucose in capillary whole blood taken from the fingertip, ventral palm, dorsal hand, upper arm, forcarm, calf and/or thigh. Element ™ plus Blood Glucose Testing System is for in vitro diagnostic use and is not to be used for the diagnosis of or screening for diabetes or for neonatal use. Element "M plus Blood Glucose Monitoring System is intended to be used by a single patient and should not be shared.

The Element ™ plus Blood Glucose Monitoring System is intended for self testing outside the body (in vitro diagnostic use) by people with diabetes at home as an aid in the management of diabetes. Alternative site Testing (ventral palm, dorsal hand, upper arm, calf and/or thigh) should be done during steady - state times when glucose is not changing rapidly.

The Element The plus Test Strips are for use with the Element™ plus Blood Glucose Meter to quantitatively measure glucose (sugar) in fresh capillary whole blood samples drawn from the fingertip, ventral palm, dorsal hand, upper arm, forearm, calf and/or thigh.

This meter contains some speaking functions but has not been validated for use by the visually impaired.

Product codes

NBW, CGA, JJX

Device Description

Element ™ plus Blood Glucose Monitoring System is comprised of test meter, test strip and control solutions. Element "" plus blood glucose test meter is substantially identical with the predicate device (Evolution "M: K072369). The minor difference is that Element "M plus test meter has voice function, which Evolution "" test meter does not have. The voice function can be used as an aid for the users to hear the test results, setting conditions and warning messages. This added function is intended to aid users' convenience.

Element 1 1 plus blood glucose test strip is identical with the predicate device (Evolution 1M. K072369) except the cover design of the test strip. Element "1" plus glucose control solutions are also exactly same as Evolution "M control solutions.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

fingertip, ventral palm, dorsal hand, upper arm, forearm, calf and/or thigh

Indicated Patient Age Range

Not Found

Intended User / Care Setting

self-testing outside the body (in vitro diagnostic use) by people with diabetes at home

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)

Clinical: The clinical performance evaluation using the Element "M plus Blood Glucose Monitoring System components were conducted for purpose of validating the consumer use for the user and the professional accuracy. Test results showed substantial equivalence.

Non-clinical: Verification, validation and testing activities were conducted to establish the performance, functionality and reliability characteristics of the Element "" plus Blood Glucose Monitoring System. The device passed all of the tests based on pre-determined Pass/Fail criteria.

Disinfection Studies: CaviWipes™ Disinfecting Towelettes (EPA Reg. No: 46781-8) was validated demonstrating complete inactivation of live virus for use with the meter and the reusable lancing device. There was also no change in performance or in the external materials of the meter and lancing device after 1,095 cleaning/disinfection cycles designed to simulate 3 years of device use.

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

Not Found

Predicate Device(s)

K072369

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 862.1345 Glucose test system.

(a)
Identification. A glucose test system is a device intended to measure glucose quantitatively in blood and other body fluids. Glucose measurements are used in the diagnosis and treatment of carbohydrate metabolism disorders including diabetes mellitus, neonatal hypoglycemia, and idiopathic hypoglycemia, and of pancreatic islet cell carcinoma.(b)
Classification. Class II (special controls). The device, when it is solely intended for use as a drink to test glucose tolerance, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 862.9.

0

NOV - 4 2

510(k) Summary

This summary of 510(K) – safety and effectiveness information is being submitted in accordance with requirements of 21 CFR Part 807.92.

Date: 09/08/2011

  1. Submission Sponsor
Submitter
NameInfopia Co.,Ltd.
Address891 Hogye-dong, Dongan-Gu, Anyang, Kyunggi,
431-080, Korea
PhonePhone: +82-31-460-0300
FaxFax: +82-31-460-0401
    1. Submission Correspondent
      LK Consulting Group 951 Starbuck St. Unit J, Fullerton, CA 92833 Priscilla Chung Phone: 714-844-2612 Fax: 714-409-3357 Email: juhee.c(@lkconsultinggroup.com

3. Device

  • · Trade Name: Element™ plus Blood Glucose Monitoring System (IGM-0021B)
  • · Classification Name: Glucose test system, Quality control material (assayed and unassayed)
  • · Classification regulation: 21 CFR Part 862.1345, 21 CFR Part 862.1660
  • · Product Code: NBW, CGA, JJX
    1. Predicate Device:

Evolution "M Blood Glucose Test System (K072369), Infopia Co., Ltd.

    1. Description:
      Element ™ plus Blood Glucose Monitoring System is comprised of test meter, test strip and control solutions. Element "" plus blood glucose test meter is substantially identical with the predicate device (Evolution "M: K072369). The minor difference is that Element "M plus test meter has voice function, which Evolution "" test meter does not have. The voice function can be used as an aid for the users to hear the test results, setting conditions and warning messages. This added function is intended to aid users' convenience.

Element 1 1 plus blood glucose test strip is identical with the predicate device (Evolution 1M. K072369) except the cover design of the test strip. Element "1" plus glucose control solutions are

510(k) Submission

1

also exactly same as Evolution "M control solutions.

  1. Indications for use:

The Element™ plus Blood Glucose Monitoring System is for the quantitative measurement of glucose in capillary whole blood taken from the fingertip, ventral palm, dorsal hand, upper arm, forearm, calf and/or thigh. Element™ plus Blood Glucose Testing System is for in vitro diagnostic use and is not to be used for the diagnosis of or screening for diabetes or for neonatal use. Element™ plus Blood Glucose Monitoring System is intended to be used by a single patient and should not be shared.

The Element™ plus Blood Glucose Monitoring System is intended for self-testing outside the body (in vitro diagnostic use) by people with diabetes at home as an aid in the management of diabetes. Alternative site Testing (ventral palm, dorsal hand, upper arm, forearm, calf and/or thigh) should be done during steady- state times when glucose is not changing rapidly.

The Element Plus Test strip are for use with the Element Plus Blood Glucose Meter to quantitatively measure glucose (sugar) in capillary whole blood samples drawn from ventral palm, dorsal hand, upper arm, forearm, calf and/or thigh.

This meter contains some speaking functions but has not been validated for use by the visually impaired.

    1. Comparison to the Cleared Device
      The modified device has the same technological characteristics as the current legally marketed predicate device, Evolution TM (K072369).

8. Performance Data

Clinical: The clinical performance evaluation using the Element "M plus Blood Glucose Monitoring System components were conducted for purpose of validating the consumer use for the user and the professional accuracy. Test results showed substantial equivalence.

Non-clinical: Verification, validation and testing activities were conducted to establish the performance, functionality and reliability characteristics of the Element "" plus Blood Glucose Monitoring System. The device passed all of the tests based on pre-determined Pass/Fail criteria.

Disinfection Studies: CaviWipes™ Disinfecting Towelettes (EPA Reg. No: 46781-8) was validated demonstrating complete inactivation of live virus for use with the meter and the reusable lancing device. There was also no change in performance or in the external materials of the meter and lancing device after 1,095 cleaning/disinfection cycles designed to simulate 3 years of device use.

2

9. Conclusion

The conclusion drawn from the clinical and nonclinical tests is that the Element ™ plus Blood Glucose Monitoring System is as safe, as effective and performs as well as the legally marketed predicate device, the Evolution TM (K072369).

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Image /page/3/Picture/1 description: The image shows the seal of the Department of Health & Human Services (HHS) of the United States. The seal features the department's name arranged in a circular pattern around an emblem. The emblem is a stylized representation of an eagle.

Public Health Service

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

Image /page/3/Picture/4 description: The image shows a date, "NOV 04 2011". The date is written in a simple, sans-serif font. The letters and numbers are bolded and evenly spaced. The image appears to be a close-up of the date.

Infopia Co., Ltd c/o Priscilla Chung LK Consulting Group 951 Starbuck St. Unit J Fullerton, CA 92833 US

K103021 Re:

Trade Name: Element plus Blood Glucose Monitoring System Regulation Number: 21 CFR §862.1345 Regulation Name: Glucose Test System. Regulatory Class: Class II Product Codes: NBW. CGA Dated: October 4, 2011 Received: October 7, 2011

Dear Ms. Chung:

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 (QS) regulation (21 CFR Part 820).

4

Page 2 -

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Office of In Viro Diagnostic Device Evaluation and Safety at (301) 796-5450. Also, please noase 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/MedicalDevicesforYou/Industry/default.htm.

Sincerely yours,

signature

Courtney H. Lias, Ph.D. Director Division of Chemistry and Toxicology Office of In Vitro Diagnostic Device Evaluation and Safety Center for Devices and Radiological Health

Enclosure

5

Indication for Use

510(k) Number (if known): K103021

Device Name: Element TM plus Blood Glucose Monitoring System

(For single patient-home use)

Indication For Use:

The Element ™ plus Blood Glucose Monitoring System is for the quantitative measurement of glucose in capillary whole blood taken from the fingertip, ventral palm, dorsal hand, upper arm, forcarm, calf and/or thigh. Element ™ plus Blood Glucose Testing System is for in vitro diagnostic use and is not to be used for the diagnosis of or screening for diabetes or for neonatal use. Element "M plus Blood Glucose Monitoring System is intended to be used by a single patient and should not be shared.

The Element ™ plus Blood Glucose Monitoring System is intended for self testing outside the body (in vitro diagnostic use) by people with diabetes at home as an aid in the management of diabetes. Alternative site Testing (ventral palm, dorsal hand, upper arm, calf and/or thigh) should be done during steady - state times when glucose is not changing rapidly.

The Element The plus Test Strips are for use with the Element™ plus Blood Glucose Meter to quantitatively measure glucose (sugar) in fresh capillary whole blood samples drawn from the fingertip, ventral palm, dorsal hand, upper arm, forearm, calf and/or thigh.

This meter contains some speaking functions but has not been validated for use by the visually impaired.

Prescription Use (21 CFR Part 801 Subpart D) And/Or

Over the Counter Use _ X (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 (OVD)

C. Davis, Jr.

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

510(k) K10302 |

510(k) Submission