K Number
K103364
Device Name
MISSION CLINICHECK ASSAYED CHEMISTRY CONTROLS, LEVEL 1, LEVEL 2, DUAL LEVEL
Date Cleared
2011-05-06

(171 days)

Product Code
Regulation Number
862.1660
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Mission CliniCheck Controls is intended for use as an assayed quality control serum to monitor the precision of laboratory testing procedures for the following analytes Acid Phosphatase (Total), Alanine Aminotransferase (ALT/GPT), Albumin, Alkaline Phosphatase (ALP), Alpha Hydroxybutyrate Dehydrogenase (a-HBDH), Amylase, Apolipoprotein A-1, Aspartate Aminotransferase (AST/GOT), Bilirubin (Direct), Bilirubin (Total), C3 Complement C4 Complement, Calcium, Carbon Dioxide (CO2), Chloride, Cholesterol (Total), HDL- Cholesterol, LDL-Cholesterol, Cholinesterase, Creatine Kinase (CK), Creatinine, Gamma Glutamyltransferase (GGT), Glucose, Immunoglobulin A (IgA), Immunoglobulin G (IgG), Immunoglobulin M (IgM), Iron, Iron Binding Capacity, Total (TIBC), Iron Binding Capacity, Unsaturated (UIBC), Lactate (Lactic acid), Lactate Dehydrogenase (LDH), Lipase, Lithium, Magnesium, Phosphorus, Potassium, Protein-Total, Salicylate, Sodium, T3 Free, T3 Total, T Free, T4 Total, Thyroid Stimulating Hormone (TSH), Transferrin, Triglycerides, Urea, Urea Nitrogen, and Uric Acid on instruments listed in the expected values chart.
Device Description
Mission CliniCheck Assayed Chemistry Control is a human serum based product containing constituents of purified biochemicals (tissue extracts of human and animal origin) chemicals, preservatives and stabilizers. Two levels of Control are provided in a lyophilized form. Each level is packaged into a glass amber bottle containing 5mL of product. The product is packaged in single level boxes (12 x 5mL) or multiple level boxes (6 x 2 x 5mL) and stored at 2 - 8°C. All human source material was tested and found negative by FDA approved methods for HBsAG, HCV, and HIV-1/2.
More Information

Not Found

No
The device is a quality control serum for laboratory testing, not a diagnostic or analytical tool that would typically incorporate AI/ML. The description focuses on the composition and stability of the control material.

No

This device is a quality control serum used to monitor the precision of laboratory testing procedures, not to treat a medical condition.

No

This device is a quality control serum used to monitor the precision of laboratory testing procedures, not to diagnose medical conditions in patients.

No

The device description clearly states it is a human serum based product in lyophilized form, packaged in glass bottles. This indicates a physical, non-software-only product.

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

Here's why:

  • Intended Use: The intended use clearly states it's for "monitoring the precision of laboratory testing procedures for the following analytes..." This indicates it's used in vitro (outside the body) to assess the performance of diagnostic tests.
  • Device Description: It's a "human serum based product containing constituents of purified biochemicals..." This is a common format for IVD control materials.
  • Function: Quality control materials like this are essential components of IVD testing workflows to ensure the accuracy and reliability of results.
  • Predicate Device: The mention of a predicate device (K093492; Mission CliniCheck Assayed Chemistry Control) further confirms its classification as an IVD, as predicate devices are typically other legally marketed IVDs.
  • Care Setting: The intended user is in "laboratory testing procedures," which is the typical setting for IVD use.

Therefore, based on the provided information, the Mission CliniCheck Controls device is an In Vitro Diagnostic.

N/A

Intended Use / Indications for Use

Mission CliniCheck Controls is intended for use as an assayed quality control serum to monitor the precision of laboratory testing procedures for the following analytes Acid Phosphatase (Total), Alanine Aminotransferase (ALT/GPT), Albumin, Alkaline Phosphatase (ALP), Alpha Hydroxybutyrate Dehydrogenase (a-HBDH), Amylase, Apolipoprotein A-1, Aspartate Aminotransferase (AST/GOT), Bilirubin (Direct), Bilirubin (Total), C3 Complement C4 Complement, Calcium, Carbon Dioxide (CO2), Chloride, Cholesterol (Total), HDL-Cholesterol, LDL-Cholesterol, Cholinesterase, Creatine Kinase (CK), Creatinine, Gamma Glutamyltransferase (GGT), Glucose, Immunoglobulin A (IgA), Immunoglobulin G (IgG), Immunoglobulin M (IgM), Iron, Iron Binding Capacity, Total (TIBC), Iron Binding Capacity, Unsaturated (UIBC), Lactate (Lactic acid), Lactate Dehydrogenase (LDH), Lipase, Lithium, Magnesium, Phosphorus, Potassium, Protein-Total, Salicylate, Sodium, T3 Free, T3 Total, T Free, T4 Total, Thyroid Stimulating Hormone (TSH), Transferrin, Triglycerides, Urea, Urea Nitrogen, and Uric Acid on instruments listed in the expected values chart.

Product codes

JJY

Device Description

Mission CliniCheck Assayed Chemistry Control is a human serum based product containing constituents of purified biochemicals (tissue extracts of human and animal origin) chemicals, preservatives and stabilizers. Two levels of Control are provided in a lyophilized form. Each level is packaged into a glass amber bottle containing 5mL of product. The product is packaged in single level boxes (12 x 5mL) or multiple level boxes (6 x 2 x 5mL) and stored at 2 - 8°C. All human source material was tested and found negative by FDA approved methods for HBsAG, HCV, and HIV-1/2.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Not Found

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Not Found

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

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

Tests were conducted to verify specific performance requirements:

  • Accelerated (high temperature) stress test was done and results support a 2 year shelf life.
  • Use life stability testing at -20 degrees C supports a 20 day life.
  • Use life stability testing under refrigerated (2-8 degrees C) conditions support a 7 day life.

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

Not Found

Predicate Device(s)

K093492

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 862.1660 Quality control material (assayed and unassayed).

(a)
Identification. A quality control material (assayed and unassayed) for clinical chemistry is a device intended for medical purposes for use in a test system to estimate test precision and to detect systematic analytical deviations that may arise from reagent or analytical instrument variation. A quality control material (assayed and unassayed) may be used for proficiency testing in interlaboratory surveys. This generic type of device includes controls (assayed and unassayed) for blood gases, electrolytes, enzymes, multianalytes (all kinds), single (specified) analytes, or urinalysis controls.(b)
Classification. Class I (general controls). Except when intended for use in donor screening tests, quality control materials (assayed and unassayed) are exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 862.9.

0

5. 510(k) Summary

510(k) Number:K103364
Applicant:Diamond Diagnostics, Inc.
333 Fiske Street
Holliston, MA 01746
MAY - 6 2011
Contact Person:Liann Voo
Director, QA and Scientific Development
Phone: (508) 429-0450 ext. 351
Fax: (508) 429-0452
Date Prepared:March 18, 2011
Classification Name:Assayed Quality Control Material
Trade Name:Mission CliniCheck Assayed Chemistry Control
Device Classification:21 CFR 862.1660
Device Class:Class I (Controls)
Classification Panel:CliniCheck Chemistry
Product Code:JJY
Intended Use:Mission CliniCheck Controls is intended for use as an assayed quality control serum to
monitor the precision of laboratory testing procedures for the following analytes Acid
Phosphatase (Total), Alanine Aminotransferase (ALT/GPT), Albumin, Alkaline Phosphatase
(ALP), Alpha Hydroxybutyrate Dehydrogenase (a-HBDH), Amylase, Apolipoprotein A-1,
Aspartate Aminotransferase (AST/GOT), Bilirubin (Direct), Bilirubin (Total), C3 Complement
C4 Complement, Calcium, Carbon Dioxide (CO2), Chloride, Cholesterol (Total), HDL-
Cholesterol, LDL-Cholesterol, Cholinesterase, Creatine Kinase (CK), Creatinine, Gamma
Glutamyltransferase (GGT), Glucose, Immunoglobulin A (IgA), Immunoglobulin G (IgG),
Immunoglobulin M (IgM), Iron, Iron Binding Capacity, Total (TIBC), Iron Binding Capacity,
Unsaturated (UIBC), Lactate (Lactic acid), Lactate Dehydrogenase (LDH), Lipase, Lithium,
Magnesium, Phosphorus, Potassium, Protein-Total, Salicylate, Sodium, T3 Free, T3 Total, T
Free, T4 Total, Thyroid Stimulating Hormone (TSH), Transferrin, Triglycerides, Urea, Urea
Nitrogen, and Uric Acid on instruments listed in the expected values chart.
Device Description:Mission CliniCheck Assayed Chemistry Control is a human serum based product
containing constituents of purified biochemicals (tissue extracts of human and animal origin)
chemicals, preservatives and stabilizers. Two levels of Control are provided in a lyophilized
form. Each level is packaged into a glass amber bottle containing 5mL of product. The
product is packaged in single level boxes (12 x 5mL) or multiple level boxes (6 x 2 x 5mL)
and stored at 2 - 8°C.
All human source material was tested and found negative by FDA approved methods for
HBsAG, HCV, and HIV-1/2.
Similarities
CharacteristicsDEVICEPREDICATE DEVICE
Mission CliniCheck Assayed Chemistry
Control, K103364Mission CliniCheck Assayed Chemistry
Control, K093492
PNDD-93001D, DD-93002DSame
Intended UseFor in vitro diagnostic use as an assayed
quality control serum to monitor the precision
of laboratory testing procedures for the
following analytes Acid Phosphatase (Total),
Alanine Aminotransferase (ALT/GPT),
Albumin, Alkaline Phosphatase (ALP),
Amylase, Aspartate Aminotransferase
(AST/GOT), Bilirubin (Direct), Bilirubin
(Total), Calcium, Carbon Dioxide (CO2),
Chloride, Cholesterol (Total), HDL-
Cholesterol, LDL-Cholesterol,
Cholinesterase, Creatine Kinase (CK),
Creatinine, Gamma Glutamyltransferase
(GGT), Glucose, Iron,[Iron Binding Capacity,
Unsaturated (UIBC)],Lactate (Lactic acid),
Lactate Dehydrogenase (LDH), Lipase,
Lithium, Magnesium, Phosphorus,
Potassium, Protein-Total, Salicylate, Sodium,
Transferrin, Triglycerides, Urea, Urea
Nitrogen, and Uric Acid on instruments which
are listed in the expected values chart.Same
MatrixSerumSame
FormLyophilizedSame
LevelsTwoSame
Storage2-8°CSame
Reconstituted
Stability20 days at -20°CSame
Shelf Life24 monthsSame

Mission CliniCheck Assayed Control 510(K103364) Al

1

Mission CliniCheck Assayed Chemistry Control, Levels 1 and 2 Predicate Device Name:

Predicate 510(k) number(s): K093492

Comparison with Predicate Device:

Differences

| Characteristics | Mission CliniCheck Assayed Chemistry
Control | Predicate |
|-----------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Constituents | Contains values for Alpha Hydroxybutyrate
Dehydrogenase (α-HBDH), Apolipoprotein A-1, C3 Complement, C4 Complement,
Immunoglobulin A (IgA), Immunoglobulin G (IgG), Immunoglobulin M (IgM), Iron Binding
Capacity, Total (TIBC), T3 Free, T3 Total, T4
Free, T4 Total, Thyroid Stimulating Hormone
(TSH). | Does not contain values for Alpha
Hydroxybutyrate Dehydrogenase (α-HBDH),
Apolipoprotein A-1, C3 Complement, C4
Complement, Immunoglobulin A (IgA),
Immunoglobulin G (IgG), Immunoglobulin M
(IgM), Iron Binding Capacity, Total (TIBC), T3
Free, T3 Total, T4 Free, T4 Total, Thyroid
Stimulating Hormone (TSH). |
| Packaging | 12 x 5 mL | 10 x 5 mL |

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Substantial Equivalence Table of Product Part Numbers & Trade Names

Diamond/Mission ProductDiamond/Mission Product
DD-93001 Mission CliniCheck AssayedDD-93001 Mission CliniCheck Assayed
Chemistry Control, Level 1Chemistry Control, Level 1
DD-93002 Mission CliniCheck AssayedDD-93002 Mission CliniCheck Assayed
Chemistry Control, Level 2Chemistry Control, Level 2
DD-93012 Mission CliniCheck AssayedDD-93012 Mission CliniCheck Assayed
Chemistry Control, Dual LevelChemistry Control, Dual Level

Assessment of Non-Clinical Performance Data:

Tests were conducted to verify specific performance requirements:

  • Accelerated (high temperature) stress test was done and results support a 2 year shelf life. .
  • Use life stability testing at -20℃ supports a 20 day life. .
  • Use life stability testing under refrigerated (2-8°C) conditions support a 7 day life. .

Assessment of Clinical Performance Data:

NA

Conclusions:

Comparison of technological characteristics, formulation and intended use to predicate device listed in this summary support the claim of substantial equivalence.

3

Image /page/3/Picture/1 description: The image is a black and white circular logo for the U.S. Department of Health & Human Services. The logo features the department's name in a circular arrangement around an emblem. The emblem depicts a stylized image of an eagle or bird with outstretched wings, symbolizing national strength and protection.

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

MAY 8 2011

Diamond Diagnostics, Inc. c/o Liann Voo, Director, Quality Assurance and Scientific Development 333 Fiske Street Holliston, MA 01746

Re: K103364

Trade Name: Mission CliniCheck Assayed Chemical Control Regulation Number: 21 CFR §862.1660 Regulation Name: Quality Control Material (assayed and unassayed) Regulatory Class: Class I, reserved Product Codes: JJY Dated: March 18, 2011 Received: March 21, 2010

Dear Ms. Voo:

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).

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Page 2 -

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 premarks notification" (21 CHR 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 tolli-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.

C.C.

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

: ১৮৮ :

Enclosure

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4. Indications for Use Statement

510(k) Number (if known): K103364

· Device Name: Mission CliniCheck Assayed Chemistry Control

Indications For Use:

Mission CliniCheck Controls is intended for use as an assayed quality control serum to monitor the precision of laboratory testing procedures for the following analytes, Acid Phosphatase (Total), Alanine Aminotransferase (ALT/GPT), Albumin, Alkaline Phosphatase (ALP), Alpha Hydroxybutyrate Dehydrogenase (a-HBDH), Amylase, Apolipoprotein A-1, Aspartate Aminotransferase (AST/GOT), Bilirubin (Direct), Bilirubin (Total), C3 Complement, C4 Complement, Calcium, Carbon Dioxide (CO2), Chloride, Cholesterol (Total), HDL-Cholesterol, LDL-Cholesterol, Cholinesterase, Creatine Kinase (CK), Creatinine, Gamma Glutamyltransferase (GGT), Glucose, Immunoglobulin G (IgC), Immunoglobulin G (IgG), Immunoglobulin M (IgM), Iron, Iron Binding Capacity, Total (TIBC), Iron Binding Capacity, Unsaturated (UIBC), Lactate (Lactic acid), Lactate Dehydrogenase (LDH), Lipase, Lithium, Magnesium, Phosphorus, Potassium, Protein-Total, Salicylate, Sodium, T3 Free, T3 Total, T4 Free, T4 Total, Thyroid Stimulating Hormone (TSH), Transferrin, Trighcerides. Urea Nitrogen, and Uric Acid on instruments listed in the expected values chart.

Prescription Use X (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 OF NEEDED)

Concurrence of CDRH, Office of In Vitro Diagnostic Devices (OIVD)

Richard Olson, C.P.A.

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

510(k) K103364