K Number
K103207
Device Name
JBAIDS Q FEVER DETECTION KIT
Date Cleared
2011-05-20

(200 days)

Product Code
Regulation Number
866.3500
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Joint Biological Agent Identification and Diagnostic System (JBAIDS) Q Fever Detection Kit is a qualitative real-time polymerase chain reaction (PCR) test kit intended to identify and detect target DNA sequence from Coxiella burnetii in serum collected from individuals suspected of having acute Q fever, typically 7-10 days after onset of symptoms or before antibody formation. This in vitro diagnostic (IVD) test is intended to aid in the diagnosis of Q fever in individuals presenting with signs and symptoms of acute Q fever when used in conjunction with other clinical and laboratory findings. This kit is only intended to aid in the diagnosis of Q fever of patients presenting in the acute stage of the disease. Negative results do not preclude C. burnetii infection and should not be used as the sole basis for diagnosis, treatment or other management decisions. The JBAIDS Q Fever assay is run on the JBAIDS instrument using the Diagnostic Wizard. Results are for the presumptive identification of C. burnetii in conjunction with serology and/or other laboratory tests. The following considerations also apply: - The diagnosis of acute Q fever must be made based on history, signs, symptoms, exposure likelihood, and other laboratory evidence, in addition to the identification of C. burnetii from serum specimens. - Sensitivity is decreased by ~25-40%, with no change in specificity, if the sample is collected after the patient has formed specific antibodies to C. burnetii, typically 7-10 days after onset of symptoms. - The definitive identification of C. burnetii from serum specimens requires additional testing and confirmation procedures in consultation with public health or other authorities for whom reports are required.
Device Description
The Joint Biological Agent Identification and Diagnostic System (JBAIDS) Q Fever Detection Kit is a fully integrated in-vitro diagnostic (IVD) system composed of the JBAIDS instrument with laptop computer, software, a freeze-dried reagent assay for the qualitative detection of pathogenic Coxiella burnetii, and 2 different sample preparation protocols for isolating target DNA from serum. Use of the JBAIDS DNA Extraction Control kit (not included) is also recommended. The JBAIDS instrument, using Polymerase Chain Reaction (PCR) technology, is a portable thermocycler and real-time fluorimeter. The JBAIDS Q Fever Detection Kit is specially designed for PCR in glass capillaries using the JBAIDS instrument and hydrolysis probes for sequence-specific detection of the C. burnetii IS1111 DNA target. The reagent kit contains 3 different types of freeze-dried reagent vials: Positive Controls, Negative Controls, and Unknowns (used for testing the patient sample). Each JBAIDS assay requires a Positive and Negative Control, and each sample is tested using an Unknown reagent vial which contains a multiplexed target and inhibition control (IC) assay. Prior to testing, serum samples are purified using the Idaho Technology IT 1-2-3™ QFLOW or IT 1-2-3™ Platinum Path Sample Purification Kit. The resulting purified sample is added to an Unknown reagent vial, along with reconstitution buffer. A Positive Control and a Negative Control vial are prepared using reconstitution buffer and reagent grade water. Aliquots from each reagent vial are transferred to 2 reaction capillaries that are tested together in the JBAIDS instrument. The instrument is programmed to perform heating and cooling cycles that drive the PCR process. The heating and cooling cycles are generated using a heating coil and varying fan speeds. Fluorescence emission is monitored over 1 of 3 wavelengths, and the instrument software interprets the change in fluorescence to determine whether the target DNA is present. When the organism is present, a fragment of C. burnetii DNA is amplified using specific primers. The amplicon is detected by fluorescence using a specific hydrolysis probe. The hydrolysis probe contains a short oligonucleotide that hybridizes to an internal sequence of the amplified fragment during the annealing phase of the PCR cycle. This probe has the 5' and 3' ends labeled with a reporter dye and a quenching dye, respectively. When the probe hybridizes to the specific DNA target, the Taq polymerase enzyme replicating the targetspecific DNA hydrolyzes the probe, which separates the two fluorophores, thus allowing the reporter dye to fluoresce. Fluorescence is monitored at a wavelength of 530 nm. Inhibition is monitored using an internal inhibition control. The inhibition control consists of a linearized plasmid containing an artificial intervening sequence flanked by target assay primer sequences. Similar to the target, the IC probe also has the 5' and 3' ends labeled with a reported and quenching dye, respectively. Hydrolysis of the IC probe during amplification is monitored at a wavelength of 705 nm. The level of fluorescence from each unknown sample and control is measured by the JBAIDS instrument. JBAIDS Software analyzes fluorescence amplification curves and reports results as Positive, Negative, Inhibited, or Uncertain. A failure of the Positive or Negative Control will result in the entire run being called Invalid. Failure of the Inhibition Control when no target amplification is observed yields an Inhibited result for the associated sample and requires retesting of that sample. A positive result for the target will override an inhibited result.
More Information

No
The device description details a standard real-time PCR system with software that interprets fluorescence curves based on predefined thresholds and controls. There is no mention of adaptive learning, pattern recognition beyond simple thresholding, or any other characteristics typically associated with AI/ML. The analysis is based on direct measurement and comparison to controls, not on learned patterns or algorithms.

No
The device is an in vitro diagnostic (IVD) test kit used to detect DNA from Coxiella burnetii in serum, aiding in the diagnosis of Q fever. It provides information for diagnosis but does not directly treat or prevent disease.

Yes

The "Intended Use / Indications for Use" section explicitly states that the kit "is a qualitative real-time polymerase chain reaction (PCR) test kit intended to identify and detect target DNA sequence from Coxiella burnetii" and "is intended to aid in the diagnosis of Q fever".

No

The device is described as a "fully integrated in-vitro diagnostic (IVD) system composed of the JBAIDS instrument with laptop computer, software, a freeze-dried reagent assay... and 2 different sample preparation protocols". This explicitly includes hardware (JBAIDS instrument, laptop) and reagents, not just software.

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

The document explicitly states in multiple places that the device is an "in vitro diagnostic (IVD) test" and an "in-vitro diagnostic (IVD) system". The intended use also describes the device as being used to identify and detect target DNA from a biological sample (serum) collected from individuals, which is a core characteristic of an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

The Joint Biological Agent Identification and Diagnostic System (JBAIDS) Q Fever Detection Kit is a qualitative real-time polymerase chain reaction (PCR) test kit intended to identify and detect target DNA sequence from Coxiella burnetii in serum collected from individuals suspected of having acute Q fever, typically 7-10 days after onset of symptoms or before antibody formation. This in vitro diagnostic (IVD) test is intended to aid in the diagnosis of Q fever in individuals presenting with signs and symptoms of acute Q fever when used in conjunction with other clinical and laboratory findings. This kit is only intended to aid in the diagnosis of Q fever of patients presenting in the acute stage of the disease. Negative results do not preclude C. burnetii infection and should not be used as the sole basis for diagnosis, treatment or other management decisions.

The JBAIDS Q Fever assay is run on the JBAIDS instrument using the Diagnostic Wizard. Results are for the presumptive identification of C. burnetii in conjunction with serology and/or other laboratory tests. The following considerations also apply:

  • The diagnosis of acute Q fever must be made based on history, signs, symptoms, exposure likelihood, and other laboratory evidence, in addition to the identification of C. burnetii from serum specimens.
  • Sensitivity is decreased by ~25-40%, with no change in specificity, if the sample is collected after the patient has formed specific antibodies to C. burnetii, typically 7-10 days after onset of symptoms.
  • The definitive identification of C. burnetii from serum specimens requires additional testing and confirmation procedures in consultation with public health or other authorities for whom reports are required.

Product codes

OVF

Device Description

The Joint Biological Agent Identification and Diagnostic System (JBAIDS) Q Fever Detection Kit is a fully integrated in-vitro diagnostic (IVD) system composed of the JBAIDS instrument with laptop computer, software, a freeze-dried reagent assay for the qualitative detection of pathogenic Coxiella burnetii, and 2 different sample preparation protocols for isolating target DNA from serum. Use of the JBAIDS DNA Extraction Control kit (not included) is also recommended.

The JBAIDS instrument, using Polymerase Chain Reaction (PCR) technology, is a portable thermocycler and real-time fluorimeter. The JBAIDS Q Fever Detection Kit is specially designed for PCR in glass capillaries using the JBAIDS instrument and hydrolysis probes for sequence-specific detection of the C. burnetii IS1111 DNA target.

The reagent kit contains 3 different types of freeze-dried reagent vials: Positive Controls, Negative Controls, and Unknowns (used for testing the patient sample). Each JBAIDS assay requires a Positive and Negative Control, and each sample is tested using an Unknown reagent vial which contains a multiplexed target and inhibition control (IC) assay.

Prior to testing, serum samples are purified using the Idaho Technology IT 1-2-3™ QFLOW or IT 1-2-3™ Platinum Path Sample Purification Kit. The resulting purified sample is added to an Unknown reagent vial, along with reconstitution buffer. A Positive Control and a Negative Control vial are prepared using reconstitution buffer and reagent grade water. Aliquots from each reagent vial are transferred to 2 reaction capillaries that are tested together in the JBAIDS instrument. The instrument is programmed to perform heating and cooling cycles that drive the PCR process. The heating and cooling cycles are generated using a heating coil and varying fan speeds. Fluorescence emission is monitored over 1 of 3 wavelengths, and the instrument software interprets the change in fluorescence to determine whether the target DNA is present.

When the organism is present, a fragment of C. burnetii DNA is amplified using specific primers. The amplicon is detected by fluorescence using a specific hydrolysis probe. The hydrolysis probe contains a short oligonucleotide that hybridizes to an internal sequence of the amplified fragment during the annealing phase of the PCR cycle. This probe has the 5' and 3' ends labeled with a reporter dye and a quenching dye, respectively. When the probe hybridizes to the specific DNA target, the Taq polymerase enzyme replicating the target-specific DNA hydrolyzes the probe, which separates the two fluorophores, thus allowing the reporter dye to fluoresce. Fluorescence is monitored at a wavelength of 530 nm. Inhibition is monitored using an internal inhibition control. The inhibition control consists of a linearized plasmid containing an artificial intervening sequence flanked by target assay primer sequences. Similar to the target, the IC probe also has the 5' and 3' ends labeled with a reported and quenching dye, respectively. Hydrolysis of the IC probe during amplification is monitored at a wavelength of 705 nm.

The level of fluorescence from each unknown sample and control is measured by the JBAIDS instrument. JBAIDS Software analyzes fluorescence amplification curves and reports results as Positive, Negative, Inhibited, or Uncertain. A failure of the Positive or Negative Control will result in the entire run being called Invalid. Failure of the Inhibition Control when no target amplification is observed yields an Inhibited result for the associated sample and requires retesting of that sample. A positive result for the target will override an inhibited result.

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

All users, analysts, and any person reporting diagnostic results from use of this device should be trained to perform and interpret the results from this procedure by JBAIDS instructors or designees prior to use. Use of this device is limited to designated Department of Defense (DoD) laboratories equipped with the JBAIDS instruments.

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)

LoD
The JBAIDS Q Fever Detection System yielded positive results 20/20 (100%) with the JBAIDS Q Fever assay for serum samples spiked with the limit of detection level (10 TCID50 mL) of live C. burnetii for both the IT 1-2-3TM Platinum Path and IT 1-2-3TM QFLOW and purification kits. In addition 10/10 (100%) of the isolates (see Table 2) included in the C. burnetii inclusivity panel were correctly identified by the JBAIDS assay the determined system LoD.

Exclusivity
The analytic specificity evaluation of the JBAIDS Q Fever Detection System was conducted with organisms that are phylogenetically related to C. burnetii, as well as with unrelated organisms that are likely to be found in clinical samples.
The JBAIDS Q Fever Detection System assays also proved to be very specific.

  • 22 of 22 non-C. burnetii strains (see Table 3) tested in the exclusivity panel were negative when tested at high concentration.
  • 2 of 2 phylogenetically related genera, Ehrlichia and Neorickettsia, were evaluated in silico. This evaluation indicated that the primers and probes in the JBAIDS Q Fever assay would not cross-react with organisms from these genera.

Reproducibility
A multicenter reproducibility study was conducted in which a panel of specimens was tested twice a day for five days at two test sites and for seven days at a third test site. Results are summarized in Tables 4 and 5, and demonstrate the JBAIDS Q Fever Detection kit provides highly reproducible test results when testing at or above the established system LoD.

Clinical Studies
In addition to analytic studies, a multisite clinical trial was conducted.
The clinical performance of the JBAIDS Q Fever Detection Kit was performed using banked, frozen serum specimens that were sequentially received during a specified time period for which standard paired serological testing for Q fever had been previously performed. Three independent laboratories (located in distinct geographical regions; Australia, France and the Netherlands) were included in this study. Serum specimens from a total of 749 subjects were evaluated in the study, however 284 were excluded (86 for inconclusive or incomplete serology, 21 due to environmental contamination, 7 for inconclusive JBAIDS results and all 170 samples tested at site 3 due to deviations from the study protocol). Table 6 provides a summary of demographic information for the 465 subjects included in this study.
Prior to testing with the JBAIDS Q Fever Detection Kit, serum samples were purified using either the IT 1-2-3 Platinum Path or the IT 1-2-3 QFLOWand sample purification kit. Out of the 465 specimens, 183 specimens had adequate volume to be purified using both purification methods. This resulted in a total of 324 final test results for Platinum Path (170 from serology positive specimens and 154 from serology negative specimens) and 324 final test results for QFLOW (171 from serology positive specimens and 153 from serology negative specimen).
Of the 307 tests of serology negative samples, 222 had no antibody to C. burnetti and 85 failed to show a 4-fold rise in antibody titer between the paired acute and convalescence samples. All but one serology negative sample, (306/307, 99.7%) gave the expected negative result when tested with the JBAIDS Q Fever Detection Kit. The one false positive was obtained from one of the samples that failed to show a fourfold rise in antibody titer.
Of the 252 tests on samples that were serology positive based upon a four-fold rise in antibodies, the JBAIDS Q Fever Detection system correctly identified the presence of C. burnetii in 17.8% (45/252) samples. However, the positive JBAIDS test result rate for those samples which exhibited seroconversion was significantly higher at 62.9% (56/89). These data are consistent with several published reports indicating that PCR detection of C. burnetii declines significantly once specific antibodies are detected by serology.
Clinical sensitivity ranged from 29-81% (variation between sites) on specimens collected prior to seroconversion.

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

LoD: 100%
Exclusivity: 100% of non-C. burnetii strains were negative.
Reproducibility: Results demonstrate highly reproducible test results when testing at or above the established system LoD.
Clinical Sensitivity:
Site 1 Platinum Path: 47% (95% CI=24-71%)
Site 1 QFLOWdna: 29% (95% CI=10-56%)
Site 2 Platinum Path: 77% (95% CI=56-91%)
Site 2 QFLOWdna: 81% (95% CI=62-94%)
Clinical Specificity:
Site 1 Platinum Path: 100% (95% CI=91-100%)
Site 1 QFLOWdna: 100% (95% CI=91-100%)
Site 2 Platinum Path: 100% (95% CI=95-100%)
Site 2 QFLOWdna: 100% (95% CI=95-100%)

Predicate Device(s)

K922374, K913906

Reference Device(s)

K051713

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 866.3500 Rickettsia serological reagents.

(a)
Identification. Rickettsia serological reagents are devices that consist of antigens and antisera used in serological tests to identify antibodies to rickettsia in serum. Additionally, some of these reagents consist of rickettsial antisera conjugated with a fluorescent dye (immunofluorescent reagents) used to identify rickettsia directly from clinical specimens. The identification aids in the diagnosis of diseases caused by virus-like bacteria belonging to the genusRickettsiae and provides epidemiological information on these diseases. Rickettsia are generally transmitted by arthropods (e.g., ticks and mosquitoes) and produce infections in humans characterized by rash and fever (e.g., typhus fever, spotted fever, Q fever, and trench fever).(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.

0

K103207

いつきのですが、そのためになるところです。 ときになると、いつきはあり、ありましていたい

MAY 2 0 2011

510(k) Summary 1 19949

510(k) Summary Idaho Technology Inc. JBAIDS Q Fever Detection Kit

| | Introduction: According to the requirements of 21 CFR 807.92, the following information
provides sufficient detail to understand the basis for a determination of
substantial equivalence. |
|------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Submitted
by: | Idaho Technology Inc.
390 Wakara Way
Salt Lake City, UT 84108

Telephone: 801-736-6354
Facsimile: 801-588-0507

Contact Person: Beth Lingenfelter, ext. 407

Date Prepared: Oct. 29, 2010 |
| Device
Name: | Trade Name:
JBAIDS Q Fever Detection Kit

Common Name:
Real-time PCR amplification and detection system for targeted Coxiella
burnetii DNA sequences |

Classification Name:

Reagent Kit: Rickettsia serological reagents (CFR 866.3500)

:
・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・

1

The Joint Biological Agent Identification and Diagnostic System (JBAIDS) Q Device Description: Fever Detection Kit is a fully integrated in-vitro diagnostic (IVD) system · composed of the JBAIDS instrument with laptop computer, software, a freezedried reagent assay for the qualitative detection of pathogenic Coxiella burnetii, and 2 different sample preparation protocols for isolating target DNA from serum. Use of the JBAIDS DNA Extraction Control kit (not included) is also recommended.

The JBAIDS instrument, using Polymerase Chain Reaction (PCR) technology, is a portable thermocycler and real-time fluorimeter. The JBAIDS Q Fever Detection Kit is specially designed for PCR in glass capillaries using the JBAIDS instrument and hydrolysis probes for sequence-specific detection of the C. burnetii IS1111 DNA target.

The reagent kit contains 3 different types of freeze-dried reagent vials: Positive Controls, Negative Controls, and Unknowns (used for testing the patient sample). Each JBAIDS assay requires a Positive and Negative Control, and each sample is tested using an Unknown reagent vial which contains a multiplexed target and inhibition control (IC) assay.

Prior to testing, serum samples are purified using the Idaho Technology IT 1-2-3™ QFLOW or IT 1-2-3™ Platinum Path Sample Purification Kit. The resulting purified sample is added to an Unknown reagent vial, along with reconstitution buffer. A Positive Control and a Negative Control vial are prepared using reconstitution buffer and reagent grade water. Aliquots from each reagent vial are transferred to 2 reaction capillaries that are tested together in the JBAIDS instrument. The instrument is programmed to perform heating and cooling cycles that drive the PCR process. The heating and cooling cycles are generated using a heating coil and varying fan speeds. Fluorescence emission is monitored over 1 of 3 wavelengths, and the instrument software interprets the change in fluorescence to determine whether the target DNA is present.

When the organism is present, a fragment of C. burnetii DNA is amplified using specific primers. The amplicon is detected by fluorescence using a specific hydrolysis probe. The hydrolysis probe contains a short oligonucleotide that hybridizes to an internal sequence of the amplified fragment during the annealing phase of the PCR cycle. This probe has the 5' and 3' ends labeled with a reporter dye and a quenching dye, respectively. When the probe hybridizes to the specific DNA target, the Taq polymerase enzyme replicating the targetspecific DNA hydrolyzes the probe, which separates the two fluorophores, thus allowing the reporter dye to fluoresce. Fluorescence is monitored at a wavelength of 530 nm. Inhibition is monitored using an internal inhibition control. The inhibition control consists of a linearized plasmid containing an artificial intervening sequence flanked by target assay primer sequences. Similar to the target, the IC probe also has the 5' and 3' ends labeled with a reported and quenching dye, respectively. Hydrolysis of the IC probe during amplification is monitored at a wavelength of 705 nm.

2

The level of fluorescence from each unknown sample and control is measured by the JBAIDS instrument. JBAIDS Software analyzes fluorescence amplification curves and reports results as Positive, Negative, Inhibited, or Uncertain. A failure of the Positive or Negative Control will result in the entire run being called Inyalid. Failure of the Inhibition Control when no target amplification is observed yields an Inhibited result for the associated sample and requires retesting of that sample. A positive result for the target will override an inhibited result.

The Joint Biological Agent Identification and Diagnostic System (JBAIDS) Q Intended Use: Fever Detection Kit is a qualitative real-time polymerase chain reaction (PCR) test kit intended to identify and detect target DNA sequence from Coxiella burnetii in serum collected from individuals suspected of having acute Q fever, typically 7-10 days after onset of symptoms or before antibody formation. This in vitro diagnostic (IVD) test is intended to aid in the diagnosis of Q fever in individuals presenting with signs and symptoms of acute Q fever when used in conjunction with other clinical and laboratory findings. This kit is only intended to aid in the diagnosis of Q fever of patients presenting in the acute stage of the disease. Negative results do not preclude C. burnetii infection and should not be used as the sole basis for diagnosis, treatment or other management decisions.

The JBAIDS O Fever assay is run on the JBAIDS instrument using the Diagnostic Wizard. Results are for the presumptive identification of C. burnetii in conjunction with serology and/or other laboratory tests. The following considerations also apply:

  • The diagnosis of acute O fever must be made based on history, signs, . symptoms, exposure likelihood, and other laboratory evidence, in addition to the identification of C. burnetii from serum specimens.
  • Sensitivity is decreased by ~25-40%, with no change in specificity, if . the sample is collected after the patient has formed specific antibodies to C. burnetii, typically 7-10 days after onset of symptoms.
  • The definitive identification of C. burnetii from serum specimens . requires additional testing and confirmation procedures in consultation with public health or other authorities for whom reports are required.

The test performance characteristics for this system were established with banked, frozen serum specimens that were sequentially received during a specified time period. The safety and effectiveness of other types of tests or sample types have not been established.

All users, analysts, and any person reporting diagnostic results from use of this device should be trained to perform and interpret the results from this procedure by JBAIDS instructors or designees prior to use. Use of this device is limited to designated Department of Defense (DoD) laboratories equipped with the JBAIDS instruments.

3

| Substantial
Equivalence: | The JBAIDS Q Fever Detection System is substantially equivalent to other
products in commercial distribution intended for similar use. The JBAIDS
instrument has been previously cleared under K051713. |

--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

The predicate for the JBAIDS Q Fever Detection Kit is the Focus Diagnostics IgM and IgG IFA tests cleared under K922374 and K913906. The following table compares the JBAIDS Q Fever Detection System with the predicate test.

Table 1. Similarities and Differences between the JBAIDS Q Fever Detection Kit and the Focus Diagnostics
IFA tests
Company of Children Children Children Children Children Children
ELEMENTJBAIDS Q Fever Detection KitFocus Diagnostics Q Fever IgG and IgM tests
Intended UseQualitative detection of C. burnetiiDetection and semi-quantitation of the human
IgG and IgM antibody response to phase I
and phase II
Coxiella burnetii antigens and as an aid in the
diagnosis of Q fever.
Indications for UseIdentification of C. burnetii in individuals
suspected of having Acute Q Fever.Serodiagnosis of both acute and chronic C.
burnetii infections.
Technological
PrinciplesReal-time PCR using hydrolysis probes.Microscopic visualization of human
antibodies for C. burnetii bacteria via a two
stage "sandwich" procedure using a
fluorescently labeled antibody that binds to
the human antibodies.
Assay TargetIS1111 DNA sequences unique to C. burnetii.Human antibody response to C. burnetii.
Specimen TypesSerumSame
InstrumentationJBAIDS instrument (K051713)Fluorescent microscope
Time Required for
Analysis of
SpecimenLess than 3 hoursSame
Sample Preparation
MethodUp front sample processing is required to
extract nucleic acid.Diluted samples are tested directly.
Sample ControlsInternal control is multi-plexed with the target
test.No sample specific control.
Testing strategyOne time point testing during the symptomatic
phase of the disease.Two serology time points are suggested. One
during the symptomatic phase of the disease
with follow-up testing 2-3 weeks later.
Optimal Window of
DetectionEarly in the disease course prior to antibody
formation.Later in the disease course due to the time
required for antibody formation.
Test InterpretationAutomated test interpretation and report
generation.Subjective interpretation by user.
Physical PropertiesFreeze dried reagents with reconstitution
buffer and water provided in kit.Liquid reagents. IgM and IgG are separate
test kits.
StorageRoom temperature (18-28°C)Refrigerator temperature (2-8°C)

The JBAIDS Q Fever Detection System is intended for the qualitative IVD detection of target DNA sequence from the C. burnetii pathogen. The system can be used to test human serum. The results from the PCR tests are used in conjunction with serology and

4

other laboratory tests and clinical information as an aid in the diagnosis of systemic Q Fever infection in individuals suspected of having the disease.

The predicate device and the JBAIDS system have a similar intended use; they both provide test results that aid in the diagnosis of O Fever when considered with other clinical and laboratory evidence.

Performance Data

LoD

The JBAIDS Q Fever Detection System vielded positive results 20/20 (100%) with the JBAIDS Q Fever assay for serum samples spiked with the limit of detection level (10 TCID50 mL) of live C. burnetii for both the IT 1-2-37M Platinum Path and IT 1-2-3TM QFLOWand purification kits. In addition 10/10 (100%) of the isolates (see Table 2) included in the C. burnetii inclusivity panel were correctly identified by the JBAIDS assay the determined system LoD.

Strain IDGroup
Nine Mile Phase II
QiYiI
RSA334I
Henzerling Phase I SalkII
M44 – GritaII
Idaho QIII
Q173-PIV
Q154-kAVIV
WAVV
Q229V

Exclusivity

The analytic specificity evaluation of the JBAIDS Q Fever Detection System was conducted with organisms that are phylogenetically related to C. burnetii, as well as with unrelated organisms that are likely to be found in clinical samples.

The JBAIDS Q Fever Detection System assays also proved to be very specific.

  • . 22 of 22 non-C. burnetii strains (see Table 3) tested in the exclusivity panel were negative when tested at high concentration.
  • . 2 of 2 phylogenetically related genera. Ehrlichia and Neorickettsia, were evaluated in silico. This evaluation indicated that the primers and probes in the JBAIDS Q Fever assay would not cross-react with organisms from these genera.

5

OrganismRelevanceConc. Tested CFU/mL
Legionella pneumophilaNearest Neighbor$10^6$
Legionella longbeacheaeNearest Neighbor$10^6$
Legionella micdadeiNearest Neighbor/Cross reactive with serology$10^6$
Bartonella henselaeCross reactive with serology$10^6$
Rickettsia prowazekiiOther small obligate intracellular bacteria, agents of zoonoses$10^6$
Mycobacterium tuberculosisSimilar symptoms$10^6$
Brucella meliteusisSimilar symptoms4.2 x $10^4$
Orientia tsutsugamushiSimilar symptoms$10^6$
Francisella tularensisSimilar symptoms4.5 x $10^5$
Salmonella entericSimilar symptoms$10^6$
Listeria monocytogenesSimilar symptoms$10^6$
Haemophilus influenzaeSimilar symptoms$10^6$
Streptococcus pyogenesCommonly encountered$10^6$
Aggregatibacter actinomycetemcomitansCommonly encountered$10^6$
Haemophilus parainfluenzaeCommonly encountered7.8 x $10^4$
Acinetobacter baumanniiCommonly encountered$10^6$
Vibrio cincinnatiensisCommonly encountered$10^6$
Escherichia coliCommonly encountered$10^6$
Staphylococcus aureusCommonly encountered$10^6$
Staphylococcus epidermidisCommonly encountered$10^6$
Pseudomonas aeruginosaCommonly encountered$10^6$
Serratia marcescensCommonly encountered$10^6$

.

Table 3, Exclusivity Panel

ldaho Technology Inc. 510(k) JBAIDS Q Fever Detection Kit

: : :

6

Reproducibility

A multicenter reproducibility study was conducted in which a panel of specimens was tested twice a day for five days at two test sites and for seven days at a third test site. Results are summarized in Tables 4 and 5, and demonstrate the JBAIDS Q Fever Detection kit provides highly reproducible test results when testing at or above the established system LoD.

Table 4. Reproducibility Study Summary (Agreement with Expected Positive Results) for the JBAIDS Q Fever
Detection Kit

| Test Level | | | IT 1-2-3 Platinum Path Sample
Purification Kit | | | | IT 1-2-3 QFLOWdna Sample
Purification Kit | | | | Both
Purification
Kits, All
Sites | 95% CI |
|-------------------------|---------------|---------------|---------------------------------------------------|-----------------|---------------|---------------|----------------------------------------------|-----------------|-----------------|------------|--------------------------------------------|--------|
| | Site 1 | Site 2 | Site 3 | All Sites | Site 1 | Site 2 | Site 3 | All Sites | | | | |
| 5X LoD | 21/21 | 15/15 | 15/15 | 51/51
100% | 21/21 | 15/15 | 15/15 | 51/51
100% | 102/102
100% | 96.5-100.0 | | |
| LoD | 21/21 | 15/15 | 15/15 | 51/51
100% | 21/21 | 15/15 | 15/15 | 51/51
100% | 102/102
100% | 96.5-100.0 | | |
| LoD/15 | 11/21 | 8/15 | 13/15 | 32/51
63% | 7/21 | 8/15 | 6/15 | 21/51
41% | 53/102
52% | 41.8-62.0 | | |
| Detection ≥
LoD | 42/42
100% | 30/30
100% | 30/30
100% | 102/102
100% | 42/42
100% | 30/30
100% | 30/30
100% | 102/102
100% | 204/204
100% | 98.2-100.0 | | |
| Detection all
Levels | 53/63
84% | 38/45
84% | 43/45
96% | 134/153
88% | 49/63
78% | 38/45
84% | 36/45
80% | 123/153
80% | 257/306
84% | 79.4 -87.9 | | |

Table 5. Reproducibility Study Summary (Average Cp and %CV) for the JBAIDS Q Fever Detection Kit

| Test

LevelIT 1-2-3 Platinum Path Sample Purification KitIT 1-2-3 QFLOWdna Sample Purification Kit
Test LocationTest LocationTest LocationAll SitesTest LocationTest LocationTest LocationAll Sites
Ave.
Cp%
CVAve.
Cp%
CVAve.
Cp%
CVAve.
Cp%
CVAve.
Cp%
CVAve.
Cp%
CVAve.
Cp%
CVAve.
Cp%
CV
5X
LoD30.942.530.812.430.301.330.712.331.531.231.251.331.531.331.451.3
LoD32.732.032.541.832.422.532.582.133.351.633.181.433.531.133.351.4
LoD/
1535.271.235.143.234.942.135.112.335.362.335.333.135.331.635.342.4

Note: Only the results for positive capillaries are included.

Clinical Studies

In addition to analytic studies, a multisite clinical trial was conducted.

The clinical performance of the JBAIDS Q Fever Detection Kit was performed using banked, frozen serum specimens that were sequentially received during a specified time period for which standard paired serological testing for Q fever had been previously performed. Three independent laboratories (located in distinct geographical regions; Australia, France and the Netherlands) were included in this

:

7

study. Serum specimens from a total of 749 subjects were evaluated in the study, however 284 were excluded (86 for inconclusive or incomplete serology, 21 due to environmental contamination, 7 for inconclusive JBAIDS results and all 170 samples tested at site 3 due to deviations from the study protocol). Table 6 provides a summary of demographic information for the 465 subjects included in this study.

SiteSite 1Site 2
Number of Subjects303162
SexFemale (%)43%31%
Male (%)57%69%
AgeMean5045
Min75
Max8782
Specimen Collection Period4/14/2008-10/15/200912/13/2005-6/26/2010

Table 6. Demographic summary for JBAIDS Q Fever clinical study

Prior to testing with the JBAIDS Q Fever Detection Kit, serum samples were purified using either the IT 1-2-3 Platinum Path or the IT 1-2-3 QFLOWand sample purification kit. Out of the 465 specimens, 183 specimens had adequate volume to be purified using both purification methods. This resulted in a total of 324 final test results for Platinum Path (170 from serology positive specimens and 154 from serology negative specimens) and 324 final test results for QFLOW (171 from serology positive specimens and 153 from serology negative specimen).

Of the 307 tests of serology negative samples, 222 had no antibody to C. burnetti and 85 failed to show a 4-fold rise in antibody titer between the paired acute and convalescence samples. All but one serology negative sample, (306/307, 99.7%) gave the expected negative result when tested with the JBAIDS Q Fever Detection Kit. The one false positive was obtained from one of the samples that failed to show a fourfold rise in antibody titer.

Of the 252 tests on samples that were serology positive based upon a four-fold rise in antibodies, the JBAIDS Q Fever Detection system correctly identified the presence of C. burnetii in 17.8% (45/252) samples. However, the positive JBAIDS test result rate for those samples which exhibited seroconversion was significantly higher at 62.9% (56/89). These data are consistent with several published reports indicating that PCR detection of C. burnetii declines significantly once specific antibodies are detected by serology.

Clinical sensitivity ranged from 29-81% (variation between sites) on specimens collected prior to seroconversion. As shown in Table 7, the clinical sensitivity for the JBAIDS Q Fever Detection Kit was different at the two study sites. Site 1 had a

8

lower detection rate (29% for specimens purified using the QFLOWd00 extraction kit and 47% for specimens purified using the Platinum Path purification kit) when compared to the detection rate at site 2 (81% for specimens purified using the QFLOWdna extraction kit and 77% for specimens purified using the Platinum Path purification kit). The differences observed at the two study sites may be the result of differences in organism strains, patient population or patient management. The clinical specificity was 100% at both sites for serology negative samples that had no antibody to C. burnetii.

Table 7. Sensitivity and Specificity for the JBAIDS Q Fever Detection Kit in Samples Tested for Acute Q Fever that were Seronegative

| Site | Purification Kit | TP/
(TP + FN) | Sensitivity
Percent | TN/
(TN + FP) | Specificity
Percent |
|------|------------------|------------------|------------------------|------------------|--------------------------|
| 1 | Platinum Path | 9/19 | 47%
(95% CI=24-71%) | 40/40 | 100%
(95% CI=91-100%) |
| 1 | QFLOWdna | 5/17 | 29%
(95% CI=10-56%) | 39/39 | 100%
(95% CI=91-100%) |
| 2 | Platinum Path | 20/26 | 77%
(95% CI=56-91%) | 71/71 | 100%
(95% CI=95-100%) |
| 2 | QFLOWdna | 22/27 | 81%
(95% CI=62-94%) | 72/72 | 100%
(95% CI=95-100%) |

Idaho Technology Inc. 510(k) JBAIDS Q Fever Detection Kit

...

9

Image /page/9/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is a stylized image of an eagle or other bird with outstretched wings.

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

Idaho Technology, Inc. c/o Beth Lingenfelter Director of Regulated Products 390 Wakara Way Salt Lake City, Utah 84108

MAY 20 2011

Re: K103207

Trade/Device Name: JBAIDS Q Fever Detection Kit Regulation Number: 21 CFR 866.3500 Regulation Name: Rickettsia serological reagents Regulatory Class: Class I Product Code: OVF Dated: May 17, 2011 Received: May 18, 2011

Dear Ms. Lingenfelter:

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 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

10

Page 2 - Beth Lingenfelter

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/cdrh/industry/support/index.html.

Sincerely yours,

Hay aAgus

Sally A. Hojvat, M.Sc. Director Division of Microbiology Devices Office of In Vitro Diagnostic Device Evaluation and Safety Center for Devices and Radiological Health

Enclosure

11

Indications for Use Form

510(k) Number (if known): K103207 Device Name: JBAIDS O Fever Detection Kit

The Joint Biological Agent Identification and Diagnostic System (JBAIDS) Q Fever Detection Kit is a qualitative real-time polymerase chain reaction (PCR) test kit intended to identify and detect target DNA sequence from Coxiella burnetii in serum collected from individuals suspected of having acute Q fever, typically 7-10 days after onset of symptoms or before antibody formation. This in vitro diagnostic (IVD) test is intended to aid in the diagnosis of O fever in individuals presenting with signs and symptoms of acute Q fever when used in conjunction with other clinical and laboratory findings. This kit is only intended to aid in the diagnosis of Q fever of patients presenting in the acute stage of the disease. Negative results do not preclude C. burnetii infection and should not be used as the sole basis for diagnosis, treatment or other management decisions.

The JBAIDS Q Fever assay is run on the JBAIDS instrument using the Diagnostic Wizard. Results are for the presumptive identification of C. burnetii in conjunction with serology and/or other laboratory tests. The following considerations also apply:

  • The diagnosis of acute Q fever must be made based on history, signs, symptoms, exposure likelihood, and other laboratory evidence, in addition to the identification of C. burnetii from serum specimens.
  • i Sensitivity is decreased by ~25-40%, with no change in specificity, if the sample is collected after the patient has formed specific antibodies to C. burnetii, typically 7-10 days after onset of symptoms.
  • .. The definitive identification of C. burnetii from serum specimens requires additional testing and confirmation procedures in consultation with public health or other authorities for whom reports are required.

Prescription Use × (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 In Vitro Diagnostic Devices (OIVD)

Ludolie K. Poole

Division Sign-Off Office of In Vitro Diagnostic Device Evaluation and Safety 510(k)_ R103267

12

Indications for Use Form

510(k) Number (if known): K103207 Device Name: JBAIDS Q Fever Detection Kit

The test performance characteristics for this system were established with banked, frozen serum specimens that were sequentially received during a specified time period. The safety and effectiveness of other types of tests or sample types have not been established.

All users, analysts, and any person reporting diagnostic results from use of this device should be trained to perform and interpret the results from this procedure by JBAIDS instructors or designees prior to use. Use of this device is limited to designated Department of Defense (DoD) laboratories equipped with the JBAIDS instruments.

Prescription Use × (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 In Vitro Diagnostic Devices (OIVD)

Freddie L. Poole

:

Division Sign-Off Office of In Vitro Diagnostic Device Evaluation and Safety 183207 510(k)